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Thread: Recommendations for a 12 cyl photochromic

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    Recommendations for a 12 cyl photochromic

    Any recommendations for a lens material/brand? The Rx is:

    R. +2.00 -12.00 x 39
    L. Plano - 6.00 x 134

    p.d. is 59 and of course he wants a Prada metal 50-18 or something, and photochromic

    (it's a 23 yo male with keratoconus. Corrects to 20/40++ in the R and 20/40-- in the left; hates contacts)

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    Master OptiBoarder ikon44's Avatar
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    what is his problem with contacts, they are his only hope of long term stable vision.
    To find out what,s happening in the UK optical market:
    http://theOptom.com

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    Underemployed Genius Jacqui's Avatar
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    1.60/1.61 index plastic, I believe AO has these in Transitions.

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    Master OptiBoarder ziggy's Avatar
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    wont there be an issue with banding with this much cyl?
    Paul:cheers:

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    Quote Originally Posted by ikon44
    what is his problem with contacts, they are his only hope of long term stable vision.
    Actually they gave him pretty decent vision, but he's pretty aware of them. I had to go large to get them to center, as he has these egg-shaped and decentered corneas. Once he gets these glasses, he may go back to them, but needs a SRx as a backup for sure.

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    Quote Originally Posted by ziggy
    wont there be an issue with banding with this much cyl?
    banding? havent heard of that. what is it?

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    Bad address email on file QDO1's Avatar
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    Quote Originally Posted by William Stacy O.D.
    banding? havent heard of that. what is it?
    its whats called the wine bottle effect... the thicker bit of the lens is darker than the thinner bit

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    Quote Originally Posted by QDO1
    its whats called the wine bottle effect... the thicker bit of the lens is darker than the thinner bit
    Shouldn't happen with Transitions like it will with Sunsensors or Photogrey

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    What about. . .

    Seikos 1.67?? I'm not sure what the parameters of the blanks are, but I know they exist in Transition. Does he have to have the transition?? He Sounds like a perfect canidate for 1.74.

    Good luck to you. I hope you're having fun and making money!!

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    As to banding, With exception of a Rhodenstock product I think all Transitions are imbibed on front surface only. Result even tint. Many years ago B&L used to make a solid UD (uniform density) sunglass product that did not change color but had a dark glass fused onto a clear blank to eliminate the "banding effect."

    But it sounds like what this patient really needs is some better fitting rigid contact lens. Or a really good smooth transplant.

    Chip

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    Master OptiBoarder ikon44's Avatar
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    Quote Originally Posted by William Stacy O.D.
    Any recommendations for a lens material/brand? The Rx is:

    R. +2.00 -12.00 x 39
    L. Plano - 6.00 x 134

    p.d. is 59 and of course he wants a Prada metal 50-18 or something, and photochromic
    If he wants to get specs you will have to dissuade him from the Pradas, way too big, I would suggest you look at the Takeo Kikuchi range from Mitani, they are top quality Titanium available in 40/42 eye sizes, but designed to fit fairly wide temples if required, they would help to reduce the off center distortion he is going to get .

    good luck
    Last edited by ikon44; 12-25-2005 at 05:22 PM. Reason: too much wine !
    To find out what,s happening in the UK optical market:
    http://theOptom.com

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    Quote Originally Posted by ikon44
    If he wants to get specs you will have to dissuade him from the Pradas, way too big, I would suggest you look at the Takeo Kikuchi range from Mitani, they are top quality Titanium available in 40/42 eye sizes, but designed to fit fairly wide temples if required, they would help to reduce the off center distortion he is going to get .

    good luck
    Thanks. Yeah I tried, but you know kids. Anyway thanks for that and all the other posts. I'll order them Tues and get back on how they came out. (Is a 12 cyl close to the world record? I had to manually hold a 6.00 cyl over my refractor [trying like crazy to keep it on axis] which only goes up to 6.00 cyl plus a 2 cyl auxiliary lens!).

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    Quote Originally Posted by William Stacy O.D.
    Thanks. Yeah I tried, but you know kids. Anyway thanks for that and all the other posts. I'll order them Tues and get back on how they came out. (Is a 12 cyl close to the world record? I had to manually hold a 6.00 cyl over my refractor [trying like crazy to keep it on axis] which only goes up to 6.00 cyl plus a 2 cyl auxiliary lens!).
    Not the record, I made a -17.00 cyl just a couple of months ago. :drop:

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    Quote Originally Posted by Jacqui
    Not the record, I made a -17.00 cyl just a couple of months ago. :drop:
    Wow. What was the sphere power? The axis? and what was the other eye?

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    Underemployed Genius Jacqui's Avatar
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    Quote Originally Posted by William Stacy O.D.
    Wow. What was the sphere power? The axis? and what was the other eye?
    I'll give you the Rx as I remember it, I may be off slightly.

    R -16.00 -17.00 @ 180
    L -15.00 -15.00 @ 20 or 25 1^Up

    Frame was a 44 or 46 small narrow oval

    Lenses were 1.67 with Zeiss Carat Advantage AR

    The last word that I got was that the patient loves them

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    Manuf. Lens Surface Treatments
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    Redhot Jumper

    Quote Originally Posted by Jacqui
    I'll give you the Rx as I remember it, I may be off slightly.

    R -16.00 -17.00 @ 180
    L -15.00 -15.00 @ 20 or 25 1^Up
    After the eggnog consumption you been describing on another thread I would suggest you repeat this post tomorrow early again....................:D

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    Quote Originally Posted by Chris Ryser
    After the eggnog consumption you been describing on another thread I would suggest you repeat this post tomorrow early again....................:D
    Only non-alcoholic eggnog here, Chris. I'll check the Rx tomorrow at the office, but I'm sure it's close. I know the Right eye is deffinately on.

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    Master OptiBoarder snowmonster's Avatar
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    Have you tried a piggyback lens system? Usually improves RGP comfort dramatically...

    -Steve

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    Quote Originally Posted by snowmonster
    Have you tried a piggyback lens system? Usually improves RGP comfort dramatically...

    -Steve
    Not yet. He may be a candidate, but I'll still need big RGPs to center, I think. Worth a try.

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    Bad address email on file QDO1's Avatar
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    Quote Originally Posted by snowmonster
    Have you tried a piggyback lens system? Usually improves RGP comfort dramatically...

    -Steve
    would you (or anyone else) explain the piggyback lens system please

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    Master OptiBoarder snowmonster's Avatar
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    Piggybacking merely refers to putting an RGP on top of a soft CL. The weird shape of keratoconic lenses makes it very difficult to get a good balance between good vision and comfort, so the soft lens acts as a buffer between the RGP and the cornea and yields much better comfort and compliance.

    I've had so many keratoconics try the RGP's under the theory that they would see better and they almost always return the lenses after a few weeks because of the comfort issues. Most of them honestly say that they don't see that badly in their glasses, even with a topographically-distorted cornea (although a 12.00 cyl would probably be an exception). So I've changed from trying to fit all keratoconics (I've seen about 30 in the past 5 years) in RGP's to keeping them in glasses until their vision is reduced enough, then I go to the RGP's but always with a soft 2-week disposable CL underneath.

    It just greatly simplifies the fit and yields better comfort for the patient at the same time.

    -Steve

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    Master OptiBoarder spartus's Avatar
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    Quote Originally Posted by ikon44
    If he wants to get specs you will have to dissuade him from the Pradas, way too big, I would suggest you look at the Takeo Kikuchi range from Mitani, they are top quality Titanium available in 40/42 eye sizes, but designed to fit fairly wide temples if required, they would help to reduce the off center distortion he is going to get .

    good luck
    I know there's little chance of talking him out of the frame, but since we're talking about it, my frame of choice for very high RXs is Prodesign 1309.

  23. #23
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    Quote Originally Posted by snowmonster
    Piggybacking merely refers to putting an RGP on top of a soft CL. The weird shape of keratoconic lenses makes it very difficult to get a good balance between good vision and comfort, so the soft lens acts as a buffer between the RGP and the cornea and yields much better comfort and compliance.

    I've had so many keratoconics try the RGP's under the theory that they would see better and they almost always return the lenses after a few weeks because of the comfort issues. Most of them honestly say that they don't see that badly in their glasses, even with a topographically-distorted cornea (although a 12.00 cyl would probably be an exception). So I've changed from trying to fit all keratoconics (I've seen about 30 in the past 5 years) in RGP's to keeping them in glasses until their vision is reduced enough, then I go to the RGP's but always with a soft 2-week disposable CL underneath.

    It just greatly simplifies the fit and yields better comfort for the patient at the same time.

    -Steve
    thanks a lot

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    It can be done.

    I have fit aproximately 30 keratoconnus patients with PMMA and/or RGP lenses per year for the last 42 years. I custom fit, change peripheral curves, diameters etc. in house. I can't recall but just a few that a: I couldn't fit comfortably. b: didn't see a lot better than best corrected spectacle acuity. c: I probably had a few that didn't succeed but I don't recall any.

    I have had some that after 1 to 4 decades did require penetrating keratoplasty due to progression of the keratoconnus, scarring, or corneal thinning.

    I suspect that those that fail as often as described in this thread are due to lack of fitter skills.

    Chip

    P.S. Most of those who had keratoplasty ended back in my office for RGP/PMMA fitting post keratoplasty.
    Last edited by chip anderson; 12-29-2005 at 08:34 AM. Reason: P.S.

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    Master OptiBoarder snowmonster's Avatar
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    I suspect that those that fail as often as described in this thread are due to lack of fitter skills.
    You sure are good.

    -Steve

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