4000 Corneas over 15 years - Data Collated

[jayuk]

Just wanted to post this link to those whom have/are going through the Transplant saga. This kind of research is what I think is needed....single eye unit/hospital; collating data and (I assume here I know!) providing quantifiable data based on real results........(but again; what a patient finds success a consultant..may not!)

http://www.cornea.org/study_database.html

[Asif]

Thanks for sharing that, proved to be an informative read. So a DALK reduces the risk of rejection by reducing the chance of endothelial cell failiure, as you would still have your own ednothelial cells present.....please correct me if I'm wrong.

After doing some research on how to prevent ocular surface disease, improving lid hygiene would be a good idea. Has anyone actually tried this by using johnsons baby shampoo and water gently on the lids of a grafted eye?

One more thing, I try to keep tap water away from my grafted eye as much as possible and so usually wear goggles when taking a shower or wash my hair seperatly. Do you think it is neccessary 8 months post graft? Keeping your eyes closed and reopening them after a shower still causes water to get into the eye.

[jayuk]

Asif

You are correct, one of the main reasons for the reduced chances of failure in DALK is that the Endothelial layer is not transplanted. A very big plus point in KC, as generaly its the front surfaces where the most change occurs.

With regards to Water in the eye, I stopped the goggle routine at 3 months (in fact I never used goggles, Id just tip my head back in shower and ensure no water entered the eye).....as after that the front layers of the cornea are definately sealed and healed. However!, there are still very minute holes where the sutures are located. This is where Chloramphenical does its main job, as it can be a place for infection to begin.

I would say 8 months is overkill; but please dont stop doing what you have done based on that opinion.....

Lid Hygeine - I cleaned my lids every morning and evening as advised by my consultant. I basically got a dab of cotton wool, some very warm water (cooled down boiled water) and swiped the lower lids; ensuring no actual water went into the eye....


J

[Andrew MacLean]

Asif

My lid washing routine involves Baby Shampoo, warm (not hot) boiled water (ie water that has been boiled in the kettle and then allowed to cool) and some cotton buds.

I make a mild solution of baby shampoo in the warm water. I them dip a cotton bud in the solution and gently wipe the edges of my eyelids with the cotton but, taking care only to use each end of the cotton bud once.

This procedure complete I rinse my eyelids with boiled water that has been allowed to go cold.

I follow this routine a couple of times a week. Other times I wash my eyes in the way described by Jay.

This was the cleaning routine reccomended by my Ophthalmologist's senior houseman after surgery.

Andrew

[Asif]

What would be better in terms of sterility, preservative-free saline or cooled boiled water. If saline is a good idea is there anywhere where i can get some single disposable saline packets, as opening after opening a 500ml ottle of saline will not still be sterile if you use it the second time. After my graft I was not told to use any methods of cleaning out the lids, just to use dexamthasone and chloramphenicol 4x a day. I was also told to avoid tap water getting into the eye for the first few months and later and would really pose a threat. I was told to stop taking chloramphenicol 2 months post.

Jay are you actually still being prescribed chloramphenicol because of your graft or do you just use it every time after a shower.

[Andrew MacLean]

Asif

I had dexamethasone and chloramphenicol. My eye was pretty well gummed up after the opeation, and I asked the doc about eye lid hygene.

Don't know if baby shampoo would dissolve in saline.

In answer to your question about single dose vials of saline is that you almost certainly can get them. I'd try a good pharmacist or high street optician. I don't think our local supermarket sells them.

Andrew

[GarethB]

Asif,

Once sterile saline is opened, can can stay effectivly sterile for a good few days later, especially is stored in a fridge.

Sterile is basically bacteria or fungi free. As long as the tip of the bottle and the inside of the lid are not touched.

My grafts are over 16 years old and I did nothing what you guys have done or are doing.

Basic everyday hygiene should be enough. Being a microbiologist, I belong to the school that beleives making our living environment sterile actually weakens the bodies defenses. This is because the natural immune system builds its own antibody database by being exposed to minor infections, a vast majority we are unaware of because the body does its thing. Stop the body doing this, should an infection come along it is unaware of what it should be doing.

That is why babies breast fed tend to suffer less illnesses than a bottle fed baby because of the antibodies from the mother passed to the baby through the breast feeding. Their immune system is being educated at an earlier stage.

Personally I would stick to basic hygiene.

[jayuk]

Asif

I dont use Chloramphenical at all now...dropped it at the 8 month mark if I recall...although I have 4 bottles in the fridge on standby as its part of my repeat prescription.......

J

[Louise Pembroke]

Interesting I didn't have a set routine after my grafts, but I always flush both eyes with hypromellose before I put my lens out and at night