Keratoconus & cornea graft question

[J_ZA]

Hi guys

I was diagnosed with keratoconus about 9 years ago and had a cornea graft in the one eye in August of this year.

My vision in the eye has improved quite a lot and there were no signs of rejection. I went to see the ophthalmologist a couple of days ago and everything is still fine but the astigmatism has gotten quite a bit worse in the last couple of days. The eye isn't red or anything.

Is this something I should be worried about? I'm using Spersadex drops twice a day and some other drops that's supposed to reduce pressure as it's on 26 at the moment, whatever that means.

Any help/advice would be much appreciated.

[GarethB]

Welcome to the forum.

Your graft is still relativeley new and it can be expected to have variations in astigmatism on the first 18 moths or so. It also depends on the type of stitches you have.

Some surgeons prefer a single stitch which not removed until at least 12 moths post graft where others use many single stitches which can be removed bit by bit to try and control the astigmatism during the healing process.

It is still early days so probably no need to be concerned at this stage post graft.

Regards

Gareth

[J_ZA]

Hi

Thanks, and thanks for the advice. I'm not 100% sure about the stitches, but the doc did say that they would only be removed after 12 months.

The thing that had me worried was the fact that the astigmatism got worse so quickly, literally within a day or 2 and it hasn't improved since.

I'm seeing the ophthalmologist again on the 9th of January next year and they'll do another screening so I'll keep you guys updated.

I must say, it's great finding a forum discussing KC.

Regards

[Andrew MacLean]

Spersadex is a compound of chloramphenicol (an antibiotic that prevents or clears up infections) and dexamethasone ( a steroid that reduces inflammation).

The down side of dexamethasone, or any other steroid, is that they can increase IOP. The normal range for IOP (for 95% of the population) is 10 mm Hg to 21 mm Hg, although some have a "normal" that is slightly higher, and others a "normal" that is lower. You are pretty close to the normal range.

If you are worried, go back to your ophthalmologist. Even if there is nothing about which you need to worry, your mind will have been put at rest. If something needs attention, it can be attended to quickly.

all the best, and welcome to the forum.

Andrew

[J_ZA]

Thx dude.

He did say that it was pretty close to normal but gave me the drops(Glaucosan 0.5%) to get it lower.

The big problem with my ophthalmologist is that he isn't very talkative - you can ask him anything and he'll just tell you not to worry about it. A visit usually consists of the usual greetings, checking the eye and telling me that everything is a-okay.

I'll keep a close eye(mind the pun) on it and if it gets any worse I'll go see him.

BTW.
I used to use Spersadex Comp but I'm on the "normal" Spersadex now. I'm not sure if it also contains dexamethasone but I'll check tonight.

[Andrew MacLean]

I think Spersadex Comp includes Chloramphenicol, but Spersadex is just dexamethasone.

Andrew

[J_ZA]

I think Spersadex Comp includes Chloramphenicol, but Spersadex is just dexamethasone.

Andrew

Ah okay, that makes sense, thx.

[J_ZA]

Hi

I went to the ophthalmologist yesterday - eye is looking good although the astigmatism is still pretty bad(measured 7 whatever that means) and the doc said he's not gonna start removing stitches yet. The pressure is also back to normal at 20 and I'm now down to 1 drop Spersadex/day.

I'm going to the optometrist tomorrow to see if anything can be done about the astigmatism for now.

Regards

[Andrew MacLean]

J_ZA

thanks for the update. All the best with your optometrist. Let us know how you get on.

The astigmatism is the bugbear of suture removal. In the UK ophthalmologist play a kind of game of chase the astigmatism as they selectively remove sutures, one here and one there, in the hope that they can encourage the new cornea to heal into a normal shape.

They seem to do a pretty good job! I am sure it will be the same in South Africa.

Andrew

[J_ZA]

Thanks, I really hope so. I'm going back to the ophthalmologist in 3 months time which will be 8 months post graft so he'll probably start removing them then.

I'm also hoping that they don't give me glasses as my eyes other eye is very light sensitive so I wear sunglasses whenever I go outside.

On that subject - check out http://www.mauijim.com

Great sunglasses for people with sensitive eyes.