DALK Done

[Andrew MacLean]

How thick does an epithelium become?

[John Smith]

Sorry Andrew - I actually have no idea how thick it becomes... it does need to be thicker than it is now though!

[Andrew MacLean]

I'll vote for that! Actually I don't need to know how thick the epithelium needs to be, indeed it is a question that had never occurred to me until I saw your post that your own epithelium was currently one layer of cells.

Andrew

[John Smith]

Well, I've kept my fingers crossed and my mouth closed for long enough.

Those of you who have looked at the photos of my graft on my blog now need to look at them again (I've added a close-up, too). At about the 2 o'clock point on the pupil (black circle) there is a foreign body. At first (like everyone on here, probably) I thought that it was simply a reflection of my camera, or something.

At my appointment last Friday (one week post-graft), my consultant told me that there was a foreign body under the graft. He had noticed the object during the operation, but thought at the time that it was simply an air bubble, and ignored it. He wasn't sure what it was, but it looked like metal, and would therefore be stainless steel, which is inert in the eye so is nothing to worry about. It would at least be sterile, so there was no danger of infection. It was not possible to remove the object without re-doing the graft completely. Also, the relatively small size of it would be akin to a bit of dirt on a camera lens - it's not great, but doesn't really affect the picture.

I'm sure that all this was meant to reassure me, but I was a bit stunned really, and after talking to a few people decided that I needed to have a second opinion.

So today, I've had a consultation with my previous consultant, whose opinion I trust and value highly.

She is a little concerned about the pressure in my recently-grafted eye (it's 24 today), but has not suggested a change in medication until I see the "new" consultant again next Friday.

As for the foreign body, she doesn't think it's metal, as it's not shiny enough, but she was at quite a loss to explain what it is - her best guess would be a bit of cellulose sponge.

There is little risk of it moving, as it's well sandwiched in place; the greatest risk would be of inflammation, but that would be low because of the absence of any blood vessels in the centre of the cornea.

All in all, this was reassuring news, as two consultants have now independantly come to the conclusion that the object is unfortunate but benign.

I think I'll sleep a little better tonight.

[jayuk]

John

How long has it been there?...As this is the ungrafted eye....and it was spotted during the graft; is it fair to say its always been there?......

Jay

[John Smith]

No, I obviously didn't make myself clear - this is in the recently grafted eye, and is obviously something that dropped in to the eye between having my own button removed and the donor button sewn into place.

[Alison Fisher]

Crikey John. That's an awful lot for you to take in and think about.

How aware of it do you think you will be once your eye has fully healed?

[Andrew MacLean]

John

This all sounds outrageous to me!

They sew a bit of sponge into your eye and tell you not to worry? They can't even agree what it is?

If I were an American Medical Malpractice Lawyer I'd be starting to look for the boat I was about to be able to buy.

All the best on Friday.

Andrew

[jayuk]

Ahhhh OK...sorry now I get it

hmm....Id be concerned as your quite rightly was....the only issue I would have if I was you; was the risk of Infection later.....right now it may be fine (hopefully it is!) but as it heals and changes take place all it takes is minute amounts of bacteria to hit the surface...and infection>possible rejection.

One thing I know is that within the cornea water is pumped in and out numerous times per day, as you know; and thus lets say for example...6 months down the line...you somewhere where theres dust?...and the eye is still in healing process; surely we increase the risk of starting/spreading an infection?...Whilst Id agree that Chloramphenical is going to be the saviour here...once its reduced...what then?

John, I by no means am an authority here.....but can I ask you pose this same question to your consultant?...as its extremely important....for you and the graft..........

I dont wana scare or try to be negative; but I am trying to be real here mate........and wouldnt want the above to really happen!

Jay

[John Smith]

Well, from a "buying a boat" point of view then I understand that to sue in the UK, you need to demonstrate "damages". OK, so it's clear that my eye is damaged, but how is it affecting me? From how it sounds, it isn't going to. I won't see it (from the inside, it can be seen from the outside without a slit lamp). I won't feel it, and it won't cause any infection (it would have done so already if it wasn't sterile).

The whatever-it-is is firmly wedged between the stroma and the endothelium, so it is unlikely to be affected by anything so simple as dust; and (it appears) it is unlikely to move.

I'm certainly not going to ignore it now, but I do feel less concerned than I was last week.