Failed Cornea Transplant

[Suzani]

Hey guys, so good to see a site dedicated to people with keratoconus. I have a very sad story to tell.

My Boyfriend and I have been together for 4 years now. He has Keratoconus and struggles to see.
He is now 23, his father passed away about 5 weeks ago, and while I was sitting in Cape Town at work he was in Bloemfontein 1000km away to be with his dad. A few hours after I received to dreadfull call to say that his father had passed on I had this brilliant idea of using his dads eyes for him. His father was 44 years old.

I had a Doctor in Bloemfontein harvest his fathers eyes, we had to donate one and my BF could use the other.

I met Christiaan half way in Oudshoorn a few days after his fathers death, as the funeral was being held there, after the funeral we had to transport the donated eye back home with us in the backseat of our car.

The operation was successfully completed... on the very last day that the cornea could still be used. I think the cornea can still be used 5 days after death.

Now... 3 weeks later and my BF still cannot see a thing, its dull, but he had no pain at all after the surgery. The doctors are very negative and they think that the cornea is not healing because we took too long to do the transplant

This is so traumatic for him, he cries and gets very frustrated. The swelling is not coming down even after every our on the dot throwing in his steroid drops.

What now? What if this cornea fails?

We went to the state hospital as we do not have any money for a medical aid, the doctors there are very good in what they do, but they dont have time to sit and actually speak to you, he doesnt know what to expect.

At the moment (3 weeks later) he has no pain, only a little bit of redness, nothing coming out of the eye, he can see a bit better than right after the operation and he can open his eye now (just ver light sensitive)

What do you guys suggest? what can he do to make this all work out? they are giving him 2 weeks to see if the cornea has healed.

I dont know whats gonna happen then??

Attached is a photo that I took just after the op. There is colorant in his eye.

[Anne Klepacz]

Hello Suzani,
What a moving story. It must be so hard for your boyfriend to be coping with mourning his father and dealing with the operation. But if he can now see a little bit better than straight after the operation then I'm not at all sure that this is a failed transplant. The vision comes back very slowly in the months after the operation, and can take up to a year. Being very light sensitive is normal after a graft - most of us wear sunglasses after the op to cope with that.
The fact that you say there's very little redness now also sounds promising. And the healing process takes different lengths of time for different people. So please don't give up hope at this stage. From what you say, it sounds as though there's a good chance that the graft will work for him. It would be wonderful if his father had given him the gift of sight.
We have someone who posts regularly here from South Africa, so would know more about how things work there. Hopefully she'll see this post.
I do hope the news will be better in two weeks time. Meantime, our thoughts and good wishes are with you both.
Anne

[Andrew MacLean]

Suzani

Welcome to the forum. Every good wish.

Andrew

[Suzani]

Thank you guys

geeezzz... Im going to ask him to join the forum. I think that you guys might be able to make him feel better. He is down in the dumps. I feel so bad being at work and him being home. He cannot sit still or rest so he walks up and down and spring cleans the flat, he also reads up on Google from his cellphone alot. I told him he shouldn't read to much now.

He went to the hospital for a check up yesterday and they changed his steroid drops from once a hour to once every 2 hours.

They said there was no change and they are waiting for the swelling to go down. Also, his eyes are very "foggy" and the cornea itself has a grey'ish/foggy color, is it normal?

[Suzani]

Okay... here is the facts:

His father passed away on the 18th of november, 3 in the morning.
The transplant was done on the 1st of December
In other words the cornea was transplanted 14 days after the harvesting of the eye. Do you guys think that it has any affect on the healing?

The Endothial is not pumping the fluids out.

In the last week the swelling did not come down at all. and he is worried about it.

[Andrew MacLean]

Suzani

It is quite common for corneal tissue to be stored for long periods prior to being used in transplant surgery. That, by itself, should not have made such a difference.

It is a worry that your endothelial cells are not working as they should. There are two ways in which corneas can be grafted; the most common in the UK is for the endothelium of the host to be left in place and the cornea without endothelium to be laminated onto the eye. I have had one of these operations; this is called a DALK or DLK transplant.

The other is for the host's endothelium to be removed and the full donor cornea to be sewn into the eye. This is called a full thickness transplant. I have had one of these operations.

From my point of view, looking out through the two grafted corneas, there is little difference in outcome.

I wonder, did you receive a DALK or full thickness graft?

Every good wish

Andrew

[Suzani]

He has 16 stitches in his eye, would that answer the question?

I think in his file at the hospital I read he has a minor corneal graft transplant...

I will confirm

[Andrew MacLean]

Not really: sixteen sutures seem pretty standard for both types of graft.

If you still have your own endothelium, that is you have had a DALK graft, they may want to talk to you about PK (full thickness) surgery.

Every good wish

Andrew

[Sheila_e]

Hi Suzani,
Welcome this site - I joined when my garft failed earlier this year, there is a lot of knowledge and support to be found here. As I said my garft did fail, what I can say is that the hospital did do everything they could before they said it had failed, and the process was very frustrating as my sight was very poor, was putting in hourly drops, with no improvment , the corneal was so thick they couldn't get and measurements, etc. and that was without the added emontional impact of your husband situation. I had a full thickness garft. I had the re garft three months after the failed one and it is going well .
wishing you both all the best
Sheila

[melissa]

hi Suzani,
sorry i didn't catch your message earlier- am away on holiday.... i am also South African and can give you some insight to the processes here (although i am on medical aid and had my graft done privately).
-as you know getting a donor cornea is one of the hardest problems here. i was told that i would have to wait 2 years, and so i 'imported' one of the excess donor corneas from the states. as a result my cornea was also quite old- i think it arrived in the country at 9 days and was transplanted at 11 days.
- i also had the problem of cloudiness- which is apparently due to the tissue soaking in too much liquid before it was inserted... my specialist was also worried that it wasn't clearing, but luckily it started clearing at 14 days
-i know it is harder at state hospitals- but keep asking questions. perhaps it would help if you wrote some of the answers down so that you can keep track.
-the vision won't improve immediately. it will take a lot of time and patience
feel free to send me a private message... and i will send you my email address...
Good luck
Melissa