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Broken Suture on Cornea Transplant Graft – How I Handled It

 

itm_l_1144Had a bit of an issue last night.  After taking out my contacts, my grafted eye started to sting like a really, really bad eyelash.  I immediately knew what it was – a suture had broken during the day.  I still have four sutures that Dr. Holland had wanted me to leave in for as long as possible.  No panic.  But time to put the plan into action.

The sensation was a sting, worse than an eyelash in my eye.  I looked at my eye carefully in mirror under magnification, and I could see a tiny little spot where the suture had been moving around.  In the center, a tiny, tiny little suture sticking straight out.   I noticed it after contact removal because my contact was acting like a bandage lens preventing the little suture from moving around.

At a previous appointment, I had asked Dr. Holland what to do if this happened, so when it did, I tried not to freak out.  I went ahead and put a drop of Vigamox (antibiotic) in before heading to bed to keep bacteria from growing in the micro-wound – with a plan to call in the morning.

Dr. Holland had previously told me that I didn’t need to drive to his office (90 minutes away) if this happened, but to just go to a local surgeon in Lexington.  I contacted Dr. Koffler’s office near my house and they had me in at 8:45, and the problem suture was out (or part of it) by 10 AM.

But the suture didn’t come out cleanly.  As you may remember from a previous post, the cornea is getting stronger all the time, and the sutures are getting pretty cemented in and losing some of their strength.  When the Dr. grabbed the eroded suture to pull it out, it broke into two pieces at the knot, and only the protruding section came out on his tweezers.  He tried to get the other one, but it was “scarred in” and he thought it better to leave it there rather than cause too many scratches on the graft.  He guessed that it would never be an issue.  Fine by me.  It would not be painful because it was under the skin.  I’ll let Dr. Holland look at it when I’m up there next.

I’m on a 4×4 regimen of Vigamox and have to leave my contact off for 48 hours, but I think all is okay.  Once this is settled, I’ll call Dr. Holland and see if he’d like to take out the rest of the sutures (so they don’t give me trouble during a business trip or otherwise inconvenient time.)

So… inconvenient, but no panic.  Rather straightforward resolution.  On with the day.

Here is an illustration of what happened to the best of my ability… the (A) is the protruding suture that was getting moved around and where things hurt.  The black dots are the knots.

graft-broken-suture

 
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Posted by on May 22, 2013 in Dr. Visits, Recovery

 

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A Boring Two Year Checkup (Boring is Good!)

Well, had my two year checkup with Dr. Holland and it was a boring visit.  No changes, no sutures out.  Boring is GOOD.

He says that we will leave the sutures in until they cause issues, and eventually one will break.  I’ll just go to a local surgeon to have them removed.  Here’s a boring image of my topography.

Everything feels fine – still using Restasis for dryness and as an anti-inflammatory -  It’s almost allergy season, so I will start my daily Zyrtec soon.

Dr. Holland re-iterated that my graft is looking good and should last the rest of my life.

2-year-topography

 
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Posted by on April 2, 2013 in Dr. Visits

 

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Two Years!

I just realized that it’s been over two years since my graft was completed.  Wow.  It seems like such a short time ago.  All’s well, and I have an appointment with Dr. Holland this week.

The image below shows me participating in the Montpelier Archaeology Team in Virginia as a metal detector expert.  Despite dusty conditions and wind, I never had a single issue with my eyes.

IMG_1302

 
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Posted by on March 20, 2013 in Diary Entries

 

Little things: PAN-STARRS comet viewing

It happens every 110,000 years.  And I saw it thanks to my improved vision.

pan-starrs

 
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Posted by on March 20, 2013 in Little Things That are Better

 

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Article: Things I learned by pretending to be blind for a week

photo by David Ball

photo by David Ball

I’ve been so busy at work lately that I’ve not been able to breathe…. but when I saw this article, I just had to share it with my readers especially since I work in this industry (user interface.)  I’m sure the low vision audience already knows this – but the others may find it very informative.

“… I started using a screen reader to see (I suppose I should say “experience”) how a blind user navigates a website..”

Read the entire post here.

 
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Posted by on January 7, 2013 in Interesting Stuff

 

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Pre Holiday Update – New Contacts Prescription

Okay this will be a short one as I’m heading home to be with family for the holiday.

After having the most recent set of sutures out, the shape of my eye shifted (as predicted) so I needed new lenses.  This presents a challenge for fitters, but one thing has made the difference… The “auto-refractor”…a device that helps contacts fitters get “close” quickly using a computerized measurement.  If your eye care provider is not using one, ask about it.

Using that piece of equipment has helped my fitter get closer to my vision needs than she seems to be able to do with manual adjustments.  Then, after the device has spit out its numbers, she refines it to the last degree by hand.  My numbers shift rather radically over time.  I previously went to see my fitter within a few days of the suture removal, and then again today (3 weeks later.)   My vision had shifted even more – so next time I will wait longer before making a fitting appointment.

I did have one nagging quality issue with the lenses – two of them got little notches around the rim for no apparent reason.  It created a mild itch, and when I looked up under the light, I could see it.  Luckily, the manufacturer will stand behind them.  This has me inclined to have an additional backup on hand.  Otherwise I’m thrilled.

A new set of lenses is on order now, to be to me after the first of the year.

Happy Holidays!

 
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Posted by on December 21, 2012 in Diary Entries, Tips

 

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Graft Looks Great – 2 More Sutures Out (and they were stubborn.)

Well, 4 months elapsed since my last visit to Dr. Holland, so I had an appointment today.  I had the usual check ups and topology.  Their office was a *zoo* … I waited 2 hours.  Thank goodness their office has Wi-Fi and I was able to do some email and watch a bit of YouTube.  Not an empty seat in the waiting rooms – and I had asked for “first appointment of the day.”

My eye pressure was 18, totally normal.  The graft was crystal clear.  No problems.  I complained about my dry eye at night and he suggested I change to a gel based lubricant and gave me some samples.  I’ve used them before and not liked their goopiness.

The topology (right) showed that it was time to remove two more sutures, so I was numbed up and Dr. Holland started the process.  It seemed to take longer than usual to cut and pull them out.  I was stone-still during this process.  Anyway, after the numbing drops wore off, it was pretty sore – yowch!  The sutures seemed to be a bit stubborn.  I think that the longer they’re in, the more they integrate into the tissue of your eye.  I took some Tylenol and started my weekend a bit early

Anyway, the usual Vigamox antibiotic dose for 3 days and go back in 4 months.

Now I will make an appointment to get fit for contacts to match my new Rx (suture removal changed my astigmatism levels.)

postscript:  Eye was completely normal the next day.  No discomfort at all. And I think my vision has improved a bit, especially with my glasses.

 
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Posted by on November 16, 2012 in Dr. Visits, Recovery

 

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