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Graft number 2

Posted: Wed 22 Sep 2021 8:09 am
by gsward
I had my first graft in January 2018 and since then things have really progressed as well as I hoped. Partially as a consequence of appointments being quite spread out since then due to Covid limitations and my vision as has been so good (I can read unaided and only need a minor prescription to drive), my surgeon has been reluctant to remove many sutures as it can change the tension and lead to astigmatism. Last week three sutures were removed, but I still have 12 or 14 remaining.

Focus (apologies for the pun) is now on the other eye. Vision with that eye has never been so good having had my first operation on it at age of two for a squint. It now has scarring from KC and there is evidence of an early cataract.
I had some interesting conversations last week. The view in the contact lens team was to fix the cataract and stick with a scleral lens to correct the vision as good as they can. However, when I discussed the options with the corneal surgeon his view was my cataract is far less of a problem than the cornea scarring and the priority should be to fix the cornea which should give a more noticeable improvement in vision.

Considering all the options the plan for mid-November is to replace my cornea and sort the cataract at the same time if all goes well on the day. I came to this conclusion as with my other eye I had to have a cataract operation some months after the graft which is not ideal for the long term life of the graft and two cycles of recovery.

Even though it has been around for a long time I still found our "When to go for a graft" article really useful. 

I hope to update in a month or so on how things work out.

Graham

Re: Graft number 2

Posted: Wed 22 Sep 2021 11:38 am
by kieran19685
How much of an improvement did you get after the 1st graft ?

Re: Graft number 2

Posted: Wed 22 Sep 2021 12:25 pm
by gsward
6/18 to 6/6 but the clarity and colour definition was much improved too.

Re: Graft number 2

Posted: Fri 24 Sep 2021 9:56 am
by Green
I really hope this works out OK Graham and I'd very much like to know how you get on. I'm awaiting a combined DMEK for PK failure & cataract op

Re: Graft number 2

Posted: Sat 20 Nov 2021 4:29 pm
by gsward
I am now ten days post-operation. The original plan was to do a PK graft and cataract at the same time. However, there had been a discussion about my case the day before I arrived on a Wednesday morning. It was explained that in my long term interests to get a better overall result it was really best to do the cataract after the graft was settled so they can insert the optimum IOL.

Added to this, rather than doing a PK there was no reason not to do a DALK as I had no damage to my endothelium unlike when I had had a hydrops in the other eye. On top of this they wanted to do what is called a 'Mushroom keratoplasty' i.e. the top half of the graft is slightly wider than the bottom. It has a normal ring of sutures on the surface but is basically a tight 'plug' underneath it.

The first stage was to cut my cornea and the donor tissue. This is gone with a topical anaestheic. The surgeon marked up the cornea with five dots by hand - the centre plus north, east, south and west! They then position you under the laser and it proceeds to join the dots and cut the profile in the cornea. It's not painful at all and only takes about 30 seconds but feels like a ton of bricks on your eye. After I left they perform the same procedure on the donor eye using exactly the same measurements. Then off to the main theatre but I don't remember any more until suddenly coming round in recovery.

Came home as planned late afternoon. I then returned for a check-up the next day and again in a week. I now don't have to go back for 4 weeks.

Overall every day now gets better and although I need the refraction sorting out the KC has gone.

Re: Graft number 2glad t

Posted: Tue 23 Nov 2021 4:33 pm
by space_cadet
glad to hear all seems to be going well for you and long may it last x

Re: Graft number 2

Posted: Wed 24 Nov 2021 9:06 pm
by RedOnion
Likewise, really glad to hear the good news and hope it continues to improve.

Re: Graft number 2

Posted: Wed 24 Nov 2021 9:13 pm
by gsward
Thank you. Now living to the drops schedule on my mobile phone!

Re: Graft number 2

Posted: Sat 27 Nov 2021 7:13 pm
by space_cadet
gsward wrote:Thank you. Now living to the drops schedule on my mobile phone!



I forget the name of the app as somehow removed it from my iphone but their is a app which lets you set different sounding alarms depending on what medication is due, it really helped me a lot a couple of years ago x

Re: Graft number 2

Posted: Thu 10 Feb 2022 10:38 am
by gsward
You will recall that it was decided at the time of the graft they would not insert the IOL lens but do that later. That second stage was completed 12 weeks to the day after the graft. The vision was good the following day and I have a scheduled review appointment in a week, but all feeling and looking good.

So how good is it overall? Without spectacles or contacts for the first time in many years, I threaded a needle first time with no hassle. I don't know where that fits on the visual acuity scale, but I'm pretty happy.