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.

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.

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.

Turns out the one with most comfort was a mini-scleral.

I hadn’t considered mini-scleral for my grafted eye, but it makes sense.  It forms a “helmet” over the graft and rests well outside my cornea.  It keeps the corneal hydrated and provides good vision.  I think I had put mini-sclerals out of my head after my less-than-stellar experience with them before my graft.  But that was not due to the lens, it was due to the cone and abrasiveness.

Anyway, I have my lens ordered and will post again when I get it in.  As usual, the Koffler staff were terrific.  By the way, Dr. Koffler was my second choice for my graft – but I just clicked better with Dr. Holland’s attitude about DALK options.  I feel confident either would do a great job, especially on a PK or other surgery.  I did apologize for being such a grump during my last visit to them 2 years ago (I was frustrated with trying to find a contact lens with a steep cone.)

Oh yes, they did a new topography.  Said it was “beautiful.”

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

Had a very good 5-month visit today where 5 sutures were removed.  We’re playing “suture roulette” now, chasing the astigmatism around my cornea.

My astigmatism went from 9 diopters to 4 diopters, which is excellent.  I’m now seeing 20/30 corrected!   The graft is also healing very well.  My steroidal dose was cut in half and my eye pressure is now stable/managed.

For the first time in 10+ years, when they adjusted the settings on the eye testing optics, I reached a 20/30 level of vision.  It used to be a pure blur.  They used to flip the lenses around and I’d say “same, same, same”…it never got better or worse.  But now, it’s like it should be.

Dr. Holland said if I was in a hurry, I could possibly get fit for contacts, but I’m going to wait and let the graft heal as long as possible.

It couldn’t have been a better visit.    Back in 8 weeks.

Roulette Wheel Photo by Photo: Heather Rai

Well, I just returned from anther follow up with Dr. Holland post-corneal transplant.  The graft and optic nerve look good, but my eye pressure is still too high – a condition known as “steroid-induced intraocular pressure.”  I’m among a small number (8%) of people who seem to have steady, ongoing eye pressure rises with use of steroids.

We’ve adjusted the type of steroids I’m using, and I’ll be taking a drop to reduce eye pressure as well (the drop is normally used for Glaucoma patients.)   I was also relieved to learn that there were no other reasons my eye pressure was rising (such as tissue or structural complications from surgery.)   Apparently that can happen with full-thickness graft, though rare.  I will be happy when the pressure is moderated – as I don’t like the sound of Glaucoma one bit!   What I think is going on is that I will be using a tiny amount of steroids – far less than most people.   This means I must be alert for any irritation symptoms.

Vision was stable, not that much better.  They claimed astigmatism was down, but I’m not seeing it.  I worked hard to see eye chart numbers.   I wish I’d brought my glasses so they could have evaluated those.  I think it will show I can see pretty damn good through them (despite the old prescription.)

But in terms of graft recovery, things looked good enough to remove a couple more sutures.   This time, the removals had a bit more of a pinch and I was slightly sore afterwards.   Tylenol and back to work.  Next time I might ask them to delay the numbing drops until right before the process itself.   There is this unpredictable delay between numbing drops and when Dr. Holland actually does the removal.   Last time, it didn’t hurt at all.    This is similar to how it went during surgery – my pain meds started wearing off before the procedure was done.  Ouch!

One Niggle… I’m consistently impressed by the Cincinnati Eye Institute Staff, but sure wish they’d dump the blaring TV’s in the waiting room.   It’s not just them, it’s everywhere.  Doesn’t anyone else like to pull out a book to read anymore?