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Corneal Transplant Recipient Getting Flu Shot? Ask Your Dr. This Question

2015-09-13 18_26_13-flu shots - Google SearchShould you protect your cornea from flu shot immunization rejection?

If you’re a corneal transplant recipient who gets flu shots, you may want to ask your corneal surgeon if you should use Tobradex (or equivalent) to avoid potential rejection due to the flu vaccine.  My particular instructions involve taking some drops a few day before my flu shot, and then for several times per day for a month afterward.  My doctor also recommended that I continue with Restasis as it provides some measure of rejection prevention.

This is done in an abundance of caution, I think.  But it’s worth a quick call to see if it might reduce your own chances for rejection.

 
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Posted by on September 13, 2015 in Recovery, Tips

 

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My DALK graft checkup – Corrected to 20/15 and Next Appt in 1-year

I just visited Dr. Holland again for a checkup.  I had a topography taken and the staff found that I was correctable to 20/15… yes… 15.   Dr. Holland said that cases like mine put to rest that vision cannot be as sharp for DALK patients.   I wore my glasses to this appointment, and corrected to 20/20 with those.

My graft is quiet and my eye pressure and corneal thickness are fine.  Dr. Holland reminded me of what to look for – light sensitivity and redness in the left eye only.  I watch it like a hawk.  He said I’m out of the major rejection period, but to always assume rejection when symptoms emerge “until proven otherwise.”

I’m to keep using Restasis 2x per day (indefinitely) … I learn a bit more each visit about how beneficial these drops are to preventing rejection.  Expensive but worth it, and better than steroids for someone like me who responds to them with increased eye pressure.

No more appointments for 1 year unless needed.

orbscan-1-4-13

 
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Posted by on January 5, 2014 in Diary Entries, Dr. Visits, Recovery

 

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Final 4 Sutures Removed

This morning I went back to Cincinnati Eye Institute and met with Dr. Holland and had the usual run through of tests. I was there 1.5 months earlier than planned because a month ago I had a suture breakage and Dr. Holland said if we start having issues with sutures that I should come see him.

The broken suture was no fun, and I have to travel some on business – was worried that would happen in an airport or in front of 200 people.

So today, he cut the last four from my graft.  There are now no mechanical connections between my body and the donor’s cornea.  That made me anxious for some reason, but I was reassured that it would be fine (unless I got boxed in the eye!)   We tested my eye pressure, vision and did a topography.  All good.

Time to remove the sutures…

dalk-cross-section

The normal drops for numbing and within 5 minutes he’d removed them.   We talked again about PRK surgery in 5-6 months and I was on my way.

Ow.

After the numbing drops began to wear off, I took a couple of Tylenol.  But it was pretty painful.  The longer sutures are in, the more they seem to hurt after removal and numbing meds wear off.

Ow. Ow. 

By 4-5 pm I was very uncomfortable, and took 1/2 of a stronger pain pill which helped.  Also added some Systane to my eye – because the pain is likely caused by the inner eyelid rubbing on the freshly cut areas of my eye.

My plan is to medicate myself liberally tonight and hope that things are better in the morning.

Our PRK discussion was about trying to get my left eye free from the need for any contacts at all.  I asked about risks and Dr. Holland made the point that the risks for PRK are about the same as long term contact lens use (infections.)  So I am strongly considering it, despite the out-of-pocket costs and another procedure on the eye.  We will discuss in 4 months.

Follow up:  2 days later.

Pain is gone and only a residual dryness remains.  I have been doing my antibiotics.  Went metal detecting Saturday and Mountain Biking Sunday and it was great.  Safety glasses for sure!

 
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Posted by on July 12, 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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Little Things: Autumn Colors in Kentucky

And without warning, seemingly overnight, Autumn has reached Kentucky.  Our trees now begin their show and we head into our relatively mild winters here.

With my new eyesight, I’ve enjoyed autumn this year more than usual.  I’ve spent days outside on weekends with my hobby and taken in every minute detail.

It’s so much more than sharpness – it’s color saturation that comes with the new eyes.

Blog Theme Update

It’s also been a long time since I’ve updated the blog’s look.  So I hope you like the new theme I’ve chosen moving us into the cooler months.

 
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Posted by on October 16, 2012 in Little Things That are Better

 

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Quick Update: No News is Good News

Hello to everyone. I’ve been getting email asking how things are going so I thought I’d post a quick update and catch everyone up. The site is seeing quite a bit of traffic

First of all, I am still wearing the soft, custom lens on my grafted eye. I’m still very pleased with it. I went ahead and ordered a couple of pair of them which should keep me going until my next appointment with Dr. Holland. If he removes sutures, my prescription is likely to change some – so I don’t want to have expensive lenses I just throw away (these lenses last 3 months.)  My vision is about the same as it was in July.  Not pin-prick-perfect, but very close.   With my right eye working with the grafted one, I have great vision.

I’m so happy with the night driving. We took a trip to Atlanta last week and I did a lot of night driving then. It was wonderful to be able to just drive on and get the trip done while others snoozed in the car.  We were going to dragon*con, and while we were there I noticed that many of the attendees in costume were wearing those weird colored contact lenses.  I shuddered to think about the damage they could do being in there for 18+ hours a day.

My allergies have been a bit of an issue, but nothing like last year. I’m taking daily allergy meds and my eyes don’t get very itchy anymore.  I take a daily Zyrtec as I’ve mentioned before.

I’m still compulsive about protecting my graft and it’s paid off recently. The other day an extension cord in my garage came down and whacked me on my safety glasses covering the grafted eye! Anytime I’m doing yard, garage or basement work, I wear something.  I think it would have hit me in the eye directly!

I don’t have that much news beyond this.

Keep the comments and questions coming – I’m happy to try to answer them.

image by Tjerk Zweers used under creative commons CC:Attribution 2.0 Generic.

 
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Posted by on September 7, 2012 in Diary Entries, Recovery

 

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Tiny Update: Soft Lenses Rock

photo (CC) Kate Ter Haar

My newest set of soft lenses are amazing.  Comfortable (16 hours+) and I can see pretty well.  Not quite as crisp as the RGP, but the comfort trade-off is worth it.  My overall vision is amazing.

I’ve ordered a few of these lenses ($50 per pair) which are custom crafted for my topography.  I’m not wanting to order too many because the shape of my eye will probably change a bit more if sutures come out, etc.

 
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Posted by on July 30, 2012 in Recovery, Vision Improvements

 

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Little Things: Stargazing

I just went on a 2 week family vacation to CA.  Lots of night driving.  Not a peep out of my contact lens, and never any pain at all and wore them for 14+ hours daily.   We went to Yosemite and at 5000 feet elevation, found a remote field and just went stargazing for a few hours with my kids.  Did you know that most kids never see a starry night?  It was the first time I’d done this since cornea transplant surgery – and it was wonderful.  I had my new soft lens in place and each star was a pinprick.  Meteors, satellites and more.   I imagined my donor out there somewhere.  I think we might join a stargazing group in Lexington.

 
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Posted by on July 23, 2012 in Little Things That are Better

 

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DALK Transplant – Stellar Follow Up + New Soft Lens Trial

photo: Logan Ingalls

Well, it’s been a good week for my DALK recovery.  I went back to Dr. Holland for my graft checkup and he said it was perfect.  I also corrected to 20/20 on their refraction gear.  I had already ordered a new, special soft contact (see last post) and was not able to take it with me to Dr. Holland.  He wasn’t bothered by that and said that if the soft lens worked for me, it would be fine for my eye.

The downside to the soft lens (at least the first one I tried) is it corrected me only slightly better than 20/30.  This means there is room for improvement.  But the comfort is … amazing!   The fitter (Tamra at Dr. Koffler’s office here in Lexington) seems to think that I should wear it for a week and then we may want to correct the power to hit near 20/20.

Other questions answered:

  • Sutures:  We’ll take them out if they degrade.  Otherwise, he said, leave them in for now.
  • Graft Fragility:  I had lots of anxiety about the graft’s fragility, but Dr. Holland told me to quit worrying.  It would take a severe trauma to disturb the graft now that it’s healed up.
  • Rejection Period:  I’m exiting the prime rejection period for DALK.
  • Glasses:  Dr. Holland said to go ahead and make the lenses for glasses.
  • PRK/Lasik is still an option if we cannot make contacts work.   Insurance won’t pay for that in KY (or OH.)
  • If we run into suture issues (e.g. one breaks) we will remove them all at once.
  • He said it was right to stop wearing the RGPs if they were hurting.  He said I should be pain free and use whatever gives that to me.

Exciting!

 
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Posted by on June 8, 2012 in Dr. Visits, Recovery, Surgery-Story

 

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Lens Difficulties (New lens ordered with different edge profile.)

Well, my first post-graft contact lens is wonderful, but I think the fit needs adjusted.

The insertion and vision have been just fine, but I’ve been having difficulties with removing the lens.  I’m competent with mini-Sclerals but this one seems too tight.  It’s nerve wracking to pull a “stuck” lens off a grafted cornea with a plunger.  I have this nighmare image that I’ll rip the graft off (I know, probably impossible.)

But this lens is too tight, so I’m going back to discuss it with the fitter.

Still thrilled!

Postscript:   Another great appointment at Koffler Vision… New lens with slightly different edge “roll” was ordered.  Also we looked at my topography to decide where it best for me to apply the plunger to remove the lens (cool use of technology!) … the traditional 6-oclock position may not be best for me – 4-oclock looks like a flat area I can use.   Will post again if I have new news!

Allergy News:  My eye has been getting red – allergies I’m pretty sure.  It’s not “rejection-red” but just red around the edges.  Any corneal transplant recipient will be hyper-vigilant about redness, so this causes some anxiety.  The best thing to do is just take some Zyrtec and check again in a day.    I’m now taking Zyertec daily again.

 

 

 
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Posted by on April 30, 2012 in Diary Entries

 

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