UK Keratoconus Self-Help and Support Association

Hi folks, had my sutures out on monday approx 16 months post graft, have been told that i will need an astigmatic keratotomy - or as my consultant put it "relaxing incisions" to improve the severe astigmatism. I didn't really get much more out of him than that, does this involve a general anaesthetic? i'm not concerned just curious....i know i'll find out soon enough anyway but it would be nice to know. Also what can i expect afterwards regarding vision/ability to drive etc?

It's strange really as this current graft seemed to go so much smoother than my first one but it seems that now all may not be so great......although i do have faith in the main man to sort it out

Hi Matty

OK - when you have a graft and they suture it, the shape that the graft takes up is reliant on how the sutures hold everything in place. Once they are taken out, two things can happen:

either everything stays the way it was

OR

the graft slightly warps now that it is not supported by the stitching.

This appears to be what happened to you, and it has resulted in a high amount of astigmatism, which means you have a lot more power in one meridian than another.

The Incisions will be done under local anaesthetic and its all quite quick. There are generally two incisions along one of the meridians to attempt to reduce the astigmatism. In my experience they work very well.

Good Luck!

Lynn

Thanks for the reply Lynn and apologies for not thanking you sooner Is it possible that a glasses prescription might not be viable if the astigmatism doesn't correct much after the incisions?

i have a feeling i might have to wear a contact lens again & i always told myself NEVER again after suffering for so many years with hard lenses & the problems that come with having KC whilst wearing contacts Regards, Matt

Matty

Relaxing incisions are often very successful, so that glasses can be worn again. Even if they cannot, you may find you can wear normal soft lenses if the astigmatism is greatly reduced.

Lynn

mmmm soft lenses

I'd be happier sticking with glasses though given the option thanks again Lynn

After all 16 of my sutures were removed I was left with a 10.5D cyl! Because of this I couldn't cope very well with specs. The cornea was very steep in one direction and flatter in the other.

I had astigmatic/arcuate keratotomy with compressive sutures a year ago in that eye. The aim of the incisions is to flatten the cornea where it is too steep, and the compressive sutures steepen the cornea where it is too flat. I now have a 2.75D cyl and can see well in specs. However some of the compressive sutures are still in place.

Following a graft, sutures are removed in areas where the cornea is too steep to help flatten it. This will help reduce the astigmatism. If a suture breaks or is removed where the cornea is already flatter it may make the vision worse by increasing astigmatism.

I had a graft in Oct 2010 and all the stitches were removed last Sept. Last month I went for a vision test (glasses) but was told the astigmatism was too severe.

Today I went back to the hospital to see the doctor. A topography of my eye was taken and the doctor said it was 12 diaopters. He said I had two options

1 - I could go back to the hospital opticians for them to try and fit a contact lens

2 - I could have refractive surgery to try and correct the astigmatism after which I would need glasses or possibly a contact lens.

I really don't want to go back to contact lenses so have opted for the surgery. I realise that if it doesn't work I'll end up with a contact lens anyway but i thought it would be worth a try.

Now I'm a bit worried as to whether I've made the right decision!! The doctor didn't go through any pros/cons with me.... what are they? Is it a good idea to be doing further surgery on a grafted eye? Will I be increasing the possibility of rejection (I've now had both eyes grafted and never had a hint of rejection)?

Any thoughts / experience on this would be much appreciated.

Thank you
Joanne

It's certainly not exact science this grafting business. Been told today I need a second Op under a full general to adjust my sutures (graft in May, adjustment November second adjustment TBA). Whilst I don't regret the graft it certainly is challenging not only for the surgeons to get a decent shape but also for the patient to cope with possible further surgery.

Ian

I had my graft a month ago ,when I asked the surgeon when the stitches might be removed ,he said he sometimes leaves some and I think he said all of them in sometimes ,if everything is ok and appears to be no problem .Has anyone else never had there stitches or no of anyone who has never had there stitches removed ?