Short diary entry – I’m back to work (5 hours today) and even bike commuted. The weather was glorious.
The itchiness vanished as mysteriously as it came and I feel SO much better. The redness in my eye is almost gone already. I’ll post an update after my follow up with Dr. Holland tomorrow afternoon. Thanks to everyone for the nice notes and well-wishes.
And while my eye looks totally normal now, I’ll still hide it behind the kitten. Now that redness is gone, you can see the bandage contact lens clearly.
Hi Scott, how is your eye after the surgery? I am considering getting the DALK as well but am not seeing much writeup about the procedure on the KC newsletter. My doctor appears to be quite competent but have not talked to any of his patients. What are some of your thoughts on this? I am quite concerned that they will switch to a full corneal transplant during the surgery- do you know if this is quite common? Thanks.
I am thrilled with the outcome so far. It has been life-changing because of the pain reduction from having KC. My vision is also better and improving. After 1 month, you’d have to remind me I had surgery – it’s that comfortable. Everyone’s different, of course. Attitude has a TON to do with it.
DALK often feels like the the desired procedure if it is possible, but full PK is also a fine outcome – both have exceptionally strong success rates, especially if you are a compliant patient. If the physician decides it’s the right thing to do, PK is *not* a failure. The big differences, as I’ve discussed in many posts here, is the potential for life-long graft life with the DALK. PK grafts usually have an outer-limit on life, but your doctor will have to give you the prognosis for your own situation. DALK also adds a shield against rejection by retaining the Decement’s membrane on the very back of the cornea. That membrane effectively fools the body’s immune system into thinking the donor cornea is your own. I joked with my doctor that it was like a corneal condom. 🙂
Going into the surgery, I had a 75% likelihood of a successful DALK procedure due to the scarring and severity of my KC. Rejection rates on the web are all over the map. Ask your doctor, but also keep in mind that most rejection episodes are managed with medicines if you act quickly. I worked with my doctor in creating a plan on what to do if I had a rejection episode (if he was unavailable, using local physicians, if I were on business travel when it happened, etc.)
It was my highest priority to find a strong surgeon with many DALK procedures behind them. Dr. Holland has to be in the top 5% in the USA. The surgeon’s experience, and attitude, about DALK are major factors. DALK is demanding on surgeons – taking much longer and requiring additional steps – and they do not receive any higher payment for the procedure. Dr. Holland was extremely “pro-DALK” but still had the credentials also. I had no worries he’d do DALK even if the surgery demanded a PK. He’s 1.5 hours’ drive away, but that’s a minor hassle.
So, I understand your concern. They may have to convert to PK during the procedure – but that is not such a bad thing.
Of course, I’m no Doctor – just a well-informed KC patient. Ask your doctor many questions (write them down… I did) and don’t hesitate to seek a surgeon who requires a drive, or even a flight to see. They can work with a local corneal physician for follow-ups to reduce the travel impact.
Good luck!