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Tag Archives: surgery-story

Little Things: Glasses after Corneal Transplant (That Work!)


oakley

A short post today.  With the sutures coming out slowly over time, it’s always been my choice to put off getting a new eyeglasses prescription.

With lenses being so expensive, and insurance limitations, it hardly made sense to pay for a new left lens every few months as my vision (astigmatism) was altered by the process.  I was already tweaking expensive contacts to follow the “suture roulette”, so I chose to hold off on the glasses.

Well, with all sutures out and a month of stabilization, I’ve finally got new lenses for my Oakley glasses.  It’s amazing to have spectacles that correct nearly as well as my contacts – and liberating.  I can now feel more confident on driving holidays where I might find myself at the wheel longer than my lens wear time allows.  And I can easily drive should a mid-night emergency happen.

Scott Clark

With allergies wreaking havoc on both eyes this Fall, I may choose to wear the glasses more often, allowing me to use eye drop antihistamines anytime I need them, avoiding the drowsiness that comes with their oral equivalent.

I cannot remember when I last had glasses that worked so well – but I’d guess it’s been nearly 15 years.

So, yet another little thing that the DALK surgery has brought me, more than two years later.

 

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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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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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Little Things: A Robin Feeding Her Young

Today I watched a robin working her nest.  My depth perception was, well, deep.  With keratoconus, I would previously have been less able to pick out the nest against the leaves in the background.  But this time, it was clear.  The colors were distinct, and the ugly little birdlings were even more homely than I recall before.   Brilliant.

 
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Posted by on April 25, 2012 in Little Things That are Better

 

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New Lens In!!!! Binocular Vision! The World is in 3D Now!

Everthing was in 3-d today!

A very big day on this long journey.  Today, I inserted the mini-scleral lenses in my grafted eye at Dr. Koffler’s office…and, for the first time in 15+ years, I had clear vision in my left eye.  My brain and eye muscles are not sure what to do with the new information so the crispness came and went, but here are my unfiltered first impressions:

  • Wow.  I can read the doctor’s diploma across the room.
  • The world is sparkly!
  • Everything’s in 3D!
  • Look at the birds!
  • Look at the clouds!!!
  • I don’t want to take this out!

I was only at a 3-hour wear limit today, so pulled them out mid-morning.  I’m looking forward to inserting them again tomorrow.

The removal was touch and go because I’m out of practice, and the eye is just slighly “dry-sore” tonight.  Nothing bad at all.  Totally expected.

I got a ‘care package’ with new plungers and other solutions, etc from the office.

NEXT UP!!!

Postscript:  Day 2, 3 of lens were tricky.  Eye was a bit sore from lens and insertion / removal was difficult.  I’m clearly out of practice on this.  Still feel a lot of anxiety about damaging my graft with lens effort.

 
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Posted by on April 24, 2012 in Recovery, Surgery-Story, Vision Improvements

 

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New – DALK Transplant Chronology

Quick post to let you know that I just made a new page which covers the chronology from my first Dr. appt to one year after the surgery.  Same posts, but in chronological order.

http://corneanews.com/about-kerataconus/chronology/

 

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Tip for Corneal Suture Removal Antibiotics – Saving a few bucks

When you are in recovery from corneal transplant, your doctor will begin removing sutures – a few at a time each visit (providing everything is going well.)  Each time you leave you’ll be asked to drop antibiotics for 3-4 days several times per day.   A tiny amount, all in all.

The tip I have is this… ask the doctor or assistants if you can have a sample antibiotic (left by drug reps) rather than a prescription.  The samples have just the right number of drops for 4×3 or 3×3 and are meant to be given away for free.  This can save you the cost of the antibiotics and a trip to the drug store.   Even ask them to give you several bottles to be used on the subsequent visit (they have a decent shelf life.)

The doctors can get more, trust me.

This might save you $30-40 per visit.Antibiotics for Corneal Transplant Suture removal

 
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Posted by on November 20, 2011 in Surgery-Story, Tips

 

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Corneal Transplant Surgery – 8-month Follow Up – Steroids to Stop in 6 Weeks.

Post Corneal Transplant Topography 8 monthsToday I went in to Cincinnati Eye Institute for my 8-month follow up with Doctor Edward Holland.   The visit followed the same routine as before – corneal surface scan, vision check, pressure check, doctor chat, and suture removal.

My vision is not changed much – and the topography showed that my astigmatism has shifted axis, and Dr. Holland adjusted his suture removal strategy.  I had two sutures out today, which was quick and painless.   My eye pressure was in the normal range and my optic nerve looked just fine.   He told me not to worry about the eye pressure as long as the optic nerve looked good.

The only big news is that in 6 weeks, I’ll be stopping my steroid drops!  This is a bit early and reflects the fact that my cornea is “crystal clear.”   I’m to watch for inflamation around the graft, but none is expected.

I hate late morning appointments.  I left Lexington at 8:30 and wasn’t back until 2:30.  My next appt is at 7:55 AM.  I’ll probably be back in Lexington by 11:00.

 
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Posted by on November 17, 2011 in Dr. Visits, Recovery, Surgery-Story

 

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DALK Checkup – A Few New Nuggets of Info

Lexington Farmer's Market

Well, today was a routine checkup.  Topography, pressure check, eye test.  Pretty much the same as the last time.  Dr. Holland removed two sutures as we continue “suture roulette.”   The graft looks great, and we’re right “on track.”

I did learn a couple of things today:

  • Peak rejection time is 8 months out from surgery.   This is for PK or DALK.  I thought it would be earlier.  This means that I must be extra diligent for RSVP symptoms between now and early next year.
  • The first sign of rejection will be redness and light sensitivity, not pain.   You should never wait for the pain if redness and pain are present.
  • When Restasis is part of your post-op drops routine, you should usually use it last.   So, for me, it’s Steroids, Pressure Med, then Restasis.
  • He suggested that I might go ahead and use Restasis in my right eye if allergies get bad again.  I think I’m through the worst of Fall allergies, however.
That’s it.
Learn more:
Oh, I really do appreciate all the messages I get about how much people are enjoying the blog.  Thanks much.
 
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Posted by on September 29, 2011 in Dr. Visits, Surgery-Story

 

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Corneal Transplant Grafts and Autumn Allergies

Lexington, KY AllergyWell, I looked at my iPhone Allergy App today and it says 10 out of 12 “Very High” for ragweed pollen – my nemesis.   Lexington is the Allergy Capital of the USA (at least in Spring,) and ragweed is the worst.  I take a daily Zyrtec which helps a lot, but several weeks out of the year it’s overwhelmed by the environment.

One interesting thing I noticed this Fall (my first with a corneal graft) is that my grafted eye doesn’t itch.   My ungrafted eye is itching like crazy.  I’m guessing it’s the nerves on the eye making the difference?  Or something about the surface that is dispersing the allergen?   Whatever, it’s a real blessing.

No matter what, I will always avoid rubbing.  Even though my right eye is past the highest risk for developing Keratoconus (I’m age 45) I still know that my corneas have a genetic weakness somewhere in there.

Everything is going great otherwise.  I’ve had a few headaches and some throbbing on my left eye.  I’m hoping it’s not eye pressure but as of the last visit that was on its way down.  I have another appointment in a couple of weeks.

 
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Posted by on August 26, 2011 in Diary Entries, Surgery-Story

 

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