UK Keratoconus Self-Help and Support Association

its been 11 months since my full penetrating cornea graft.

must say i havnt had any problems apart from one stitch out that was loose but i didnt notice it was.

My eye sight is really goo in the grafted eye and with glasses gets me vision that i havnt had since a child.

The last time i saw my doctor he said that he wants to avoid taking my stitches out for a wile now as im getting good vision, and he said i will hate him wen he finally does take them out as my vision will get worse.

This really confused me as ive waited all year to have them out as a goal or target and now i dont want to have them out lol

can anyone tell me if this information is true? will my eyesight get worse when he takes the stitches out? does this mean i will never get good vision like i have now in that eye? will it be a case of the vision will get worse wen they are taken out then start to improve again? lots off questions there i know but will really appreciate the advise, this is the only place i can talk about my eye condition as on1 els understands.

thanks

steve

Hi Steve,
Great news you're getting good vision post graft.
I gather - though she hasn't said it to me herself - that my new consultant (ie. the one who, or whose team, I see now, not the one who did my graft) tends to leave stitches in permanently, unless they are actually causeing problems, so yours wouldn't be alone in not wanting to remove them. (My is a single zigzag running stitch; I gather yours are several single ones.)
What happens -= as understand it - when stitches are removed is like this.
First, for a while the eye might be a bit sore and the vision blurred, and you may have to (go back to) putting drops in for a while. This stage shouldn't be long - oh, I dunno, w few days or a week.
After that, your eye is likely to change shape, or to have changed shape, slightly, because the stitches are no longer holding it in the precise shape it was in before.
This may mean you need new glasses, or new contact lenses, to correct your vision from the amended shape.
I don't know any particular reason why new glasses/lenses shouldn't correct to as good as you were before - though of course, this is a biological living system we're talking about, and they all have minds of their own and don't necessarily follow the rule books!
It's also possible the eye might change shape gradually over a while, with the stitches no longer holding its shape, and you may need new glasses again.... and maybe again.... till it is finally stable.
I don't know any reasons for not leaving the stitches there, so long as they are not working loose, pulling, or anything and the consultant is happy with them being there. They can always be taken out later, which is less trouble than taking them out and later finding they need putting back.
Rosemary

Yes, well done Steve.

When the sutures are removed from your eye, the cornea will no longer be held in its current position; it may take some weeks or even months for it to settle into its final shape and at that time you will be able to have a lens or glasses that will give you good correction.

Nil desperandum!

Andrew

thanks both of you for your quick reply's.

It seems a shame that i will have to take a step back in vision when I've come so far, i think i understand what you are saying though. When the 15 stitches are taken out the eye will change shape again. Its just not nice waiting for the stitches to come out if you know what i mean, i wonder how much the eye has actually healed now.

I thought things where going too smoothly lol not had any rejections episodes or anything. guess the only problems i have is that i still have to wear a thick lens in my other eye which makes me feel a bit of a freak, and that dry eye feeling which i'm guessing is the stitches, not sure.
'
but apart from my moaning i'm so happy that i had it done and grateful. if i could get my other eye done i would do it tomorrow. nothing worse than these thick lenses lol

Your surgeon can actually see how well your eye has healed when he or she looks through the slit lamp. In my own experience they did not start removing sutures until they were entirely satisfied that my eyes had healed sufficiently for the new corneas each to be able to stay in place by themselves.

All the best.

Andrew

Did you have both corneas done at once Andrew? how long did they take to come out? one good thing i found through this is that no one has noticed the stitches in my eye, just the redness i get sometimes.

No, they were done two and a half years apart. My first graft (PK in the right eye) was done when I was already blind. To be honest I didn't really know any dramatic difference after the graft, but gradually I did see the return of sight. the sutures came out in two batches: eight in one go and the other eight in the next.

The most dramatic improvement came after the removal of the first eight; that would be 18 months after surgery. When they removed the rest of the sutures from that eye, my sight did go back a little, but then it improved in leaps and bounds until I was able to get part of the line below 6/6 (corrected). I wear glasses now and they give me very good sight indeed through my right eye.

The second (DALK in my left eye) seemed to heal more quickly and all sixteen sutures were removed in one go at just over a year. I am having a new contact lens fitted in that eye, and expect to have as good sight with it as I do with my other.

All the best

Andrew

So you wear one contact lens and glasses? What sort of contact lens do you wear? is it still a big thick one? or is it just a normal one?

I'm between lenses just now, but I hope for another Scleral (big thick one). The Scleral is still by far the most comfortable lens I have ever worn.

But, yes, I wear glasses with an optical value in the right lens, and no optical value in the left. I wear and will wear again a lens in my left eye!

Oh joy!

Andrew

Hi Steve

I had a continuous stitch in one graft and individual ones in the other.

The continuous one was in my first graft and was taken out roughly eighteen months post graft. I don't recall any significant affect on my vision, just a sore eye for a few days, oh, and going back to putting drops in for a short while too.

The stitches in my second graft have been taken out if they have started to bother me, which is something I appear to be ultra sensitive to so I've had many trips to eye casualty. I think I have half a dozen or so still in, and expect to have them for the rest of my life. Late last year they tried to take two out but after all this time they had become very brittle and so caused a lot of problems. Three weeks, four hospital visits, one very sore eye and two doctors having a go later they finally got the first out and decided to leave the other well alone. I would love to have them all out so I know they'll never bother me again but it isn't to be. As with my first graft I have never noticed any significant change in sight/prescription when I've had any taken out.

If you do have yours taken out it isn't as bad as you might imagine it to be. A few slightly odd sensations as the stitch is first broken and then pulled on but no particular pain. I'd much rather have a stitch out than go to the dentist's - even when it's only for a check-up!