UK Keratoconus Self-Help and Support Association

Haven't been on this site for a while but thought I would let you know how things are going.
After having partial thickness graft in my right eye in Dec 05 I seem to have had all the bad luck. Stitches have come loose, re stitched, running stitches out then single ones put it, these stitches removed apart from 2 and I still don't have vision in this eye.
The eye went back to being keratoconic but the single stitches still didn't work and although the graft has healed well and is really clear, my vision isn't!!
I am having a replacement graft in this eye on 14th Oct and I hope that this will be more successful!!
My right eye is not functioning with a scleral lens so I've had a year with a white stick.

Has anyone else had a second graft after their first one failed due to the lack of vision and eye becoming cone shaped again?

Sophie I hope your graft is still doing well and the 'lifting' problem you have had is sorted out. What is happening with your other eye? Are you having Intacs?

Hi Kim,

My thoughts are with you, especially as it has taken 16 years for my right graft to get near to what you are experiencing. I can still see out of the right eye, even if all I can make out is smudges of colour, but get fitted for a new lens soon, so hopefully this will help.

I am wondering if the eye had healed well (although partially with running stitches), that the individual ones were not enough to pull it back to shape. Personally I think single stitches are the best as you have the ability to control the astigmatism more as the cornea heals again.

I had this type of stitching in both eyes 16 years ago and was told it will do away with the running stitches because of problems they can cause. The single stitches and the surgeon are the reason my grafts have lasted so well 16 years on.

Will you have single stithes this time?

Good luck and let us know how it goes.

Regards

Gareth

Hi Gareth
One of the problems I have had is that I have healed at an incredible rate.
Although I had around 12 single stitches put in after the running stitches were removed the problem hasn't been solved by this, and even after taking certain stitches out at different times it hasn't helped.
That's a really good point about what stitches I'm having this time. I hadn't even asked!

I hope you get good results from your new lens.

Kim


Are you certain the KC has occured or was it that the removal of stitches has left you severely astigmatic?....thats a extremely quickre-occurence of KC in the eye TBH......what does your consultant say?

Kim,

Just noticed you are in Durham, what hospital did you have the graft done and by whom?

Mine was done at the Memorial (?) in Darlington by James Haslam.

Your healing quick does clarify my gut feeling (poor medical diagnosis on my part and not scientifically accurate). It makes me more convinced that as Jay says KC probably has not reuturned, you just heeled too quick and when the running stitch was replacxed, unfortunatly the damage was done and the cornea was in the wrong shape giving the KC profile.

See if you can specify the stitches you would like and push the healing quick thay have already acknowledged. Hopefully the follow ups will be more frequent which I am sure you will tolerate if it menas the graft heals more uniformly givving you sight that can be corrected with glasses.

I healed quite quick that some stitches were removed early as the cornea was growing over them. I still have a couple where the cornea did just that and it would be too damaging to dig down and remove.

Good luck and keep us posted.

Regards

Gareth

Sorry, I didn't explain myself very well. Yes I haven't got KC in my grafted eye, it's just that the shape is like KC. On the topography it looks just like KC.
I had my op at Sunderland and have had very frequent visits there. Almost every week it seems.
They are very aware of my quick healing and I am seeing the surgeon next week when I can talk about stitches. The first stitches I had put in, cut through my cornea (called cheese-wired) which is why I had it tightened and then a couple of months later had the single stitches.
I'm not quiet sure of what you mean about having more appts and do you think that I should have single stitches? Do you think it hasn't worked because i had the zig zag stitches which then cut through my cornea and so became loose, which then didn't hold my graft in the correct shape?
I welcome your thoughts
Many thanks

You have it the nail on the head regarding my thoughts.

By more appointments, I mean have the checks post graft more frequently to take into account your more rapid healing. That way if the shape of the graft needs adjusting by removing the stitches, the graft can still move. I think if you heal too quick, the stitches are removed but the graft is holding so well, the shape does not change shape into a more normal curvature.

My honest perosnal view is that single stitches give more flexibility to finely adjust the shape of the cornea to get the best shape throughout the healing process.

These are just my thoughts, but if it helps you come up with questions you can discuss with your consultant so this graft works in the way you wish.

Gareth

Many thanks Gareth

Hi

With regards to the stitching

Its generaly thought that the "Zig Zag" or "continuous" sutures are put in place to hold the cornea back and not to protrude

The Single stiches are used to ensure proper re-attachement to the host cornea.

I have both....and right now gng through the single stiches being removed few at a time.....

I have looked into this and also asked soo many questions around this.....and its generally thought that if you ONLY have the single sutures the graft can fly off.....welll not fly off....but can deattached slightly easier......when applying sudden or sligh pressure..some 3 montsh after.......

Do you know how much Astigmatism you have? it it over 10 diopters?

I'm not quiet sure what it is but I have been tried with diagnostic lenses and something about it being -20. I know that it wasn't possible to correct it with lenses or glasses.
What you're saying about the continuous stitch does seem to have been used at first to hold it back. Obviously it didn't work and the tension couldn't be increased too much as it was cutting through my cornea. I'm having a full graft this time. Do you think that will make a difference?
Many thanks