Everything with my eyes is great.  I continue annual exams which include a look at the graft and it has been completely quiet.  My allergies kick in occasionally but I manage those with Allegra.

I’ve been doing Tobradex (a combination of tobramycin and dexamethasone) prior to influenza vaccines and COVID shots, but I’ve recently learned that this may not be required?   I’m planning to ask my doctor soon.  If it’s not, I’ll update the posts I have on here about using it.

I spend a lot of time hiking, mountain biking and kayaking with my wife. 

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…

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!

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.

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!

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

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.