Hydrops Concern

[fatar760]

Hello,

I had CXL done in my right eye 2 months or so ago. Although I feel there has been slight deterioration in that eye I'm aware that it could still take a bit of time to settle.

My current concern though is with my left eye.

The vision in my left eye has been very poor for some time. I wear a RGP lens in that eye and have done for 15 years or so. I was recently told that there are early signs of hydrops developing in that eye and so have booked to have a half-graft done in a few weeks (I'm sure it's not exactly called a half-graft but I hope it makes sense). Anyway, I'm due to have this done towards the end of September. Should I still be wearing my hard lens in that eye? or will it affect the procedure? I've started feeling fluid in my eye, it may well be nothing, it's certainly not painful and I don't feel my vision has changed. maybe my eye is just missing wearing the lens? I'm just concerned that I may be developing hydrops which will leave scarring and prevent me from having the half-graft.

Any advice or hearing of people's experiences may help put my mind at ease (I'm going to call the opthalmologist tomorrow too)

[Andrew MacLean]

I think that by "Half Graft" you probably mean a DALK. This is where they remove the front of your own cornea, leaving the endothelium in place. They remove the endothelium from the donor cornea and sew the front of the healthy cornea onto your eye. Most grafts in the UK are on this pattern, although if the clinical indicators are not right for a DALK the surgeon can easily switch to doing a PK (full thickness graft).

Sometimes, people who have had Hydrops need to have the full thickness graft.

If your operation is scheduled for the next week or so, it may be that you need not worry. That said, in your place i'd make an appointment to see my optometrist to ask about wearing the lens in the build up to surgery.

Every good wish

Andew

[fatar760]

Hi Andrew,

Thanks for the reply.

You're right it is a DALK. On Tuesday I decided to go and see the person who is doing the op to check everything was ok. It turns out my cornea is weakening and developing further signs of Hydrops (I think the term began with an E but i can't remember what it is called)So anyway, the surgery has now been brought forward to next wednesday, which is a little daunting, but necessary.

I've had conflicting advice about continuing to wear the lens. On Tuesday he told me that i should continue to wear it as it is acting as a buttress for my cornea. I then received an email yesterday telling me not to wear it for 5 days beforehand and that the cost had gone up nearly £2000. I know this isn't the first case of this.

[Lynn White]

Hi Fatar

As far as the contact lens is concerned, it sounds like he first advice is specific to you and the second relates to general information sent out automatically before an operation. However, if in any doubt, recheck with your professional again.

Lynn

[rosemary johnson]

I think you are right to be concerned.
It sounds odd to me.
OK - I'm not a medic and I javent seen your eye n particular.
But
1. I'm surprised you would have a hydrops and not know it - the world tends to go very misty (from foggy day look to a complete white out
2. why is anyone trying to graft you with an active hydrops??? - I've always een led to beleive that trying to do a transplant on an eye that is soggy with an unresolved hydrops (ie. where the membrane is still split and the tissues still got some waterlogging) is not good as it does not give a good prognosis; it is better to wait till the split has healed and the tissue dried out, as that is likey to give a better result and furthermore it allows a better view of how the eye is doing after the hydrops and whether a graft is really going to be all that necessary
3. why are they wanting to do a DALK - partial-thickness graft - when there is an issue with hydrops anyway? - as it is the layer that splits to cause the hydrops that is left behind for the partial thickness donor cornea to be grafted onto. Surely, if they try to do a DALK and graft a partially thickness donor cornea onto a lower layer that is split and leaking ecause it has an active hydrops, all that will happen is that you'll vry rapidly get the donor cornea that is transplanted in all waterlogged and misted over so you can't see out of it.
Now, there may be good reasons to their thinking, and as I said, I'm not a medic - but No. 3 in particular makes no sense to me (as a veteran of at least 4 hydrops and a disastrous graft-gone-wrong! There may e good answers, but in your position I'd certainly want to be asking the questions.
GOod luck with it all,
Rosemary