Wearing a contact lens post graft

[craigthornton]

Sorry if I am repeating myself at the first bit of this post but not all of you will know my history.

Last December I had a graft on my right eye and it was healing nicely. In July, while dreaming, I hit the eye so hard the lens part behind the iris came out and the graft had to be re-stitched as emergency surgery.

The re-stitched graft was healing well and 3 weeks ago they removed a stitch. I went back yesterday and went for a (refraction?) test. With corrected vision, despite no lens, I could read to the third from bottom line.

This was a great improvement from 3 weeks ago and so the consultant said for now he does not want to remove any more stitches and will wait for the cornea to totally heal. In 18 months or so they will remove the remaining stitches and correct my vision by a contact lens or artificial lens implant.

I asked if anything could be done for now for the astigmatism as this is the most dibilitating matter for me. He has booked me in for an appointment with the "standard" contact lens clinic where I used to go when I just had KC before the hydrops occured.

It wasn't until I came away that I thought, hang on, why can I not have a vision-corrected lens now but can have one from the lens clinic.

Is this because my prescription will change somewhat over the 18 months, and will the lens clinic just give me a non-prescription lens to help mould the shape of the cornea and correct the astigmatism?

Also I am very anxious about wearing a lens on a stitched cornea. I imagine the cornea becoming unstitched as I squeeze my eyelids at night to take out the contact lens! Can anyone reassure me?

[martwoman]

Hi Craig
sorry not been on the forum for a whilr been on hols and busy ar work. my consultant said to me after having my graft done that i will not be able to wear a contact lens in grafted eye until the stitches have all been removed but this mahes do difference to me at the mo any way as i hadn't worm them in that eye for well over a year due very bad keractoconus(lens kept falling out litteraully straigtht after inserting) and also due to being intolerant to them due to allergies. Although when i went to clinic the other monday they referrered me to have an eye test(didnot see either of the doctors i usually one on hol the other sick and i saw the same lady that i had seen in the morning in contact lens clinic(for left eye lens out more then in due to allergies) and we managed to get good vision and i could read the third line down clearly and was able to read the fourth line down although very blurry. She said this was a very high prescription but would give us some were to start when i have the stitches out and am reffered to contact lens clinic for right
So as far as I am aware is is usuall for stitches to be removed before being able/aloud to wear lenses i seem to remember my consultant saying something about this being standard procedure, but your consaltant may be taking in account the fact that you do not have
a natural lens due to you unfrutumate accident and think it would benifit you to have a contact lens. I also seem to remember you saying in a previous post that your under QMC in notts although you said it was a different consultant you were under but you think mine was the one you saw when you had your accident as yours was on hol correct me if i have this wrong. it seams to me that the suggestons and recommansations made by consultants don't just very from hospital to hospital but from consultant to consultant with in the same hospitals. I know i have probably not been of much use but glad that things are going well for you
Take care
martwoman

[Anne Klepacz]

Wow! You're getting great vision with your graft despite your 'mishap'. But yes, the vision post-graft does keep gradually changing as the graft settles in, and will change again as and when you have stitches removed. So you won't know the final results until all the stitches are out. You'll need to discuss your concerns at the contact lens clinic, but if it's any help, I did eventually wear a contact lens on my first grafted eye while the sutures were still in because I needed at least one 'seeing' eye for the second eye to be grafted. It needs more than just taking a contact lens in or out to loosen stitches (unless your technique for removing lenses is as violent as your punches!)
Anne

[martwoman]

hi again
forgot to mention that my consultant also said before op that my presciption could change alot of the healing period especially the first few months so it wouldn't be benifical to me to have glasses as they would need replacing quite regurly and would not be cost affective for me althought i would probably need some form of correction once it has healed either by glasses or lens so this probably why your consultant is only sending you to have a standard lens fitted as you probably know aswell as i and either KC lens wearer only know to well that lens are quite expensive so if they need replacing quite alot it is money down the pan so to speak although if after my graft has healed and my prescrition still changes quite alot i would rather pay for new lens that struggle with ones that are wrong despite the fact that my lens is out more often then not in the left eye usually only manage to were it about once a month an thats usaally for about three hours despite usinh drops for my allergies etc. it is still a good fit and the correct prescibtion for me according to the contact lens specialist they also said were it as often as i can and thatr it sound like i am doing all the right things to be able to try and were as she is a were that i don't have the best conditions for wearing lens as many of us KC suffers are only to a were.
again
take care
martwoman

[craigthornton]

Anne, I meant I could read that far down the chart once they put in different lenses in the "glasses frame".

Or did you know that and mean it was good anyway as I don't have a natural lens? I must admit my consultant, who isn't that expressive usually, was very pleased with the results.

I am wearing a guard every night now, not risking anything. Wonder how many miles of tape I will get through over the rest of my lifetime?!

[Andrew MacLean]

craigthornton

I thought you meanst "corrected vision", and I agree with Anne; that's pretty good! Well done.

All the best

Andrew

[craigthornton]

When testing my eyesight, some of the lenses seemed to correct my astigmatism quite a bit. Is that really possible? I thought you had to wear contact lens for the type of astigmatism I have.

Maybe the astigmatism I have now is mild compared to when I had KC and so can be corrected other ways.

[Andrew MacLean]

I think it depends on how steep your astigmatism is. I have glasses that correct for the astigmatism in my right eye, but will need a contact lens for the left.

Andrew

[Anne Klepacz]

Craig - I have to confess I thought you meant uncorrected! (Another senior moment as I did wonder why you wanted a lens). But it's still good if spectacles give you such improvement. With any luck, the graft will have got rid of all irregular astigmatism which is such a pain in KC and you're just left with some astigmatism from the graft itself. And it's quite possible that will be able to be corrected with glasses. Since my grafts, I can now get good vision with glasses. So I now wear contact lenses for part of the day and switch to glasses when I've had enough of them. It's wonderful to have that choice. But as I said before, you won't really know what the final effect will be until all the sutures are out and the graft has finally settled down. Good luck!
Anne

[GarethB]

Craig

Glasses are unable to correct irregular astigmatism and some higher order aberations. Post graft you may still have astigmatism, but far less irregular astigmatism that you eye can compensate.

One of the things I have discussed with the contact lens manufacturer I have been working with is the possibility of their new soft lens which we know to work post graft for me being used much earlier post graft such as while you still have the stitches in. My theory was that it would get both eyes working together quicker and they agree.

So far I have found the soft lens to match the performance of an RGP but with with superior comfort, far better than the other soft lenses I've tried in the past.