Problems Post Graft Latest

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Liam
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Problems Post Graft Latest

Postby Liam » Sun 15 Feb 2009 12:21 pm

Thank you to all those who replied to my post 09th February 2009 especially Andrew,Graeme,Gareth and Melissa.It's a long story but as to how I got an earlier appt !

I think the result may be of interest to KC sufferers as it transpires that my gritty feeling in my eye (for the last 2 months) was not due to an eye infection or dry eye but to my graft having moved, thereby creating what they call a step.I am unsure as to what it exactly means but I think that something/somewhere is rubbing against my corneal tissue etc

Has any other member of the group encountered this "step" before and also does anyone know how a graft can move if it is stitched into place ?

Regds,

Liam

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Andrew MacLean
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Re: Problems Post Graft Latest

Postby Andrew MacLean » Sun 15 Feb 2009 4:57 pm

Liam

Many, if not most grafted corneas have a 'step' at the edge of the grafted tissue where it meets with the host eye. The extent to which this step is manifest will vary and the whole idea of the sutures that hold the cornea in place is to minimize the step at the interface.

I think that it is more difficult to get a smooth finish when performing a DALK graft than an old fashioned PK. If you think about this:

Take a black grape and a green grape.

Use a trepaine to cut out a perfect circle of skin from each.

Now try to put the disk of skin of the black grape into the gap in the skin of the green grape. The curve of the two grapes may vary slightly, so that you have to decide on having either a crease or a further cut and a step ...

Life is hard for the ophthalmologist.

Andrew
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rosemary johnson
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Re: Problems Post Graft Latest

Postby rosemary johnson » Sun 15 Feb 2009 10:08 pm

ANybody who's wondering how things can shift when they are sewn in place may care to thinko of this.
Take a pair of jodhpurs. Or if you prefer Lycra cycling shorts.
These do quite a lot of sitting in saddles, bending and stretching, as the wearer's legs move and back leans forwards of backwards. Also bending down to pump up tyres/clean out hooves and other bits of maintenance, and let us hope not too often end in heap on ground having fallen off respective mounts.
And suppose the seat of said apparel wears thin, and you sew a patch across said seat.
And after a few five-mile rides, take a look at the state of the stitches.
OK, one's eyes may not get treated to anything like the rigours of the bum of one's lycra shorts. But you get the picture.
Rosemary
whose mum sewed a patch onto the um of her jodhs using the sort of zigzag running stitch she has in her grafted eye, and it came undone in no time.

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Andrew MacLean
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Re: Problems Post Graft Latest

Postby Andrew MacLean » Mon 16 Feb 2009 12:38 pm

rosemary: In my time I have work jodhpurs but I have never worn anything made of lycra. thank you, none the less, for putting an image in my mind of one rather tubby slightly bald and late-middle-aged Scottish Clergyman wearing inappropriate cycling shorts.

Liam: It is often because of an uneven join between grafted tissue and host eye that many graftees wear contact lenses after their transplant operation. That said, it is probably very much too soon to be able to tell whether you will settle down to life without needing correction to your vision, or with glasses, or indeed with contact lenses.

Take care.

Andrew
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nicola jayne
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Re: Problems Post Graft Latest

Postby nicola jayne » Mon 16 Feb 2009 1:57 pm

Hiya Liam
My graft shifted last year and I had the graft cracked open and moved back and re stitched again. I can not remember if I had stitches in it at the time though sorry.
lol sorry I can not be any more help.
nicola

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GarethB
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Re: Problems Post Graft Latest

Postby GarethB » Mon 16 Feb 2009 4:03 pm

My optoms have often said fitting a contact lens is like finding a lens that fits three different eyes. It needs to correct for any abnormalities in the graft, plus the host and the interface between the two.
Gareth


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