Might be some silly questions

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Amer
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Might be some silly questions

Postby Amer » Wed 11 Jun 2008 5:30 pm

Hi,

I have KC like a lot of people on this site but my KC only affects one eye. I have finally decided to go for a corneal graft and had my pre op appointment yesterday. I know rejection can happen and that it is reversible, but once the graft has bonded and the stitches have been removed. can the graft still reject?, can rejection occur 5 or 10 years later? And how long will the graft last, i was looking at some websites and they said that corneal grafts can last up to 15 years but when i asked my surgeon who will performing the surgery he said the graft will last a lifetime. I have trust in my surgeon, but theres still that doubt in the back of my mind whether this is the right thing to do.

The other thing i wanted to find out about was will i be able to workout after the op, i know this has been answered in the faq, but at the moment i lift quite heavy weights, would i be able to get back to this after a year or 18 months or will the cornea always be weaker so i will have to opt for lower weights and not be able to get back to it in the same way

These might be silly questions and sorry if they have been answered before, i just couldn't find the right info.

oh my ops on the 27/06/08 so not too far away

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Andrew MacLean
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Re: Might be some silly questions

Postby Andrew MacLean » Wed 11 Jun 2008 5:52 pm

Amer; there is no such thing as a silly question.

Yes, grafts can reject even after the sutures come out. In fact you could have a rejection episode even years after the surgery; most corneal transplants are successful. Nevertheless, recognizing the warning signs is the best way to prevent corneal transplant rejection. Familiarize yourself with the four main signs by remembering the acronym RSVP:

Redness
Extreme Sensitivity to light
Decreased Vision
Pain

If you are worried about the health of your graft go back to the hospital right away. If you want to rread more about cornea grafts I found this article very helpful:

http://www.allaboutvision.com/condition ... splant.htm

It may be that your surgeon is going to do a DALK rather than PK graft. I have never heard of a DALK graft rejecting.

As to lifting weights, you would be better to be guided by your surgeon. I have never lifted very heavy weights, but was able to get back to moderate exercise six weeks after surgery. :D

All the best, and welcome to the forum!

Andrew
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rosemary johnson
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Re: Might be some silly questions

Postby rosemary johnson » Wed 11 Jun 2008 5:59 pm

Hallo Amer,
Good luck with the graft. Where are you having it done?
Yes, grafts can reject at any time. Though it is said that the longer ago they were done, and less likely it is they will start to reject if they haven't done before.
I've met someone who had grafts done 40 years ago. I mean, 40 years ago at the tme I met her. We said she must have had them done very young!!
As regards lifting - I was told not to lift anything heavy for about 6 weeks. I don't go and do weights in the gym, but I have a part share in a horse, so do a lot of lifting and carrying his bales of hay, and sacks of wood shavings for the bed in his stable.
I couldn't do that for a while, but do now (four and a half months on). Also water buckets..... though I still don't attempt to push up the ramp on the horsebox on my own.
In fact, I found it was fairly easy to tell in the early days if I was trying to overdo something - I could feel the eye "pulling" and knew that meant to stop.
I suspect you may be advised to work up again gradually, with the weight training. But I don't see why you shouldn't get back to where you were.
You medical team will advise, I@m sure.
Rosemary

Amer
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Re: Might be some silly questions

Postby Amer » Wed 11 Jun 2008 6:57 pm

Thanks for the replies,

I'll getting my op done in Glasgow at the Gartnavel Hospital, the surgeon who will be doing it will be Ramaesh. I think some of the Scottish members will know of him.

I will need to remember to ask him whether it will be a partial or a full thickness graft. I've been told that i will have to stay in the hospital for the first night as well. The graft will be done on friday morning and then i will be allowed to go home on the saturday, I just assumed it would be done on an out patient basis. I don't mind though. its just really scary at the moment.

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Re: Might be some silly questions

Postby Andrew MacLean » Thu 12 Jun 2008 6:18 am

Amer

If you live a distance from the hospital they like you to stay overnight so that you can attend a clinic first thing on the Saturday morning.

I am a patient at Gartnavel and Dr Ramaesh did the grafts into each of my eyes. My first graft was a PK because of the deep scarring in my cornea that had already damaged the endothelium. My second graft was a DALK. One of the games that Dr Ramaesh likes to play with his Scooby Crew is to ask them to tell him which of my eyes had a PK and which a DALK. :D

I rate Dr Ramaesh very highly indeed. Indeed I rate the whole institute of ophthalmology at Gartnavel very highly indeed.

All the best

Andrew
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alvin18
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Re: Might be some silly questions

Postby alvin18 » Thu 12 Jun 2008 1:50 pm

Andrew MacLean wrote:...
It may be that your surgeon is going to do a DALK rather than PK graft. I have never heard of a DALK graft rejecting.
...



Silly question here too. What is different between DALK and PK graft? I'd just like to know which one I have.

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Andrew MacLean
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Re: Might be some silly questions

Postby Andrew MacLean » Thu 12 Jun 2008 2:06 pm

Alvin

there is still no such thing as a silly question.

A DALK is sometimes knows as a 'partial thickness' graft. When removing the cornea from the recipient's eye they leave behind the back layer of cells (the 'endothelium'). They then peel the endothelium from the donated tissue and graft the donated cornea onto the host's own endothelium.

A PK is sometimes known as a 'full thickness' graft. When removing the cornea from the recipient's eye they take away all of the cornea (three layers: epithelium, stroma and endothelium). They then graft the donated tissue into the host's eye.

http://www.amnitrans.nl/content.php?na=55

Andrew
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alvin18
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Re: Might be some silly questions

Postby alvin18 » Thu 12 Jun 2008 2:28 pm

thanks fo reply. have to ask my surgeon which one i have, i think its PK.

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Alison Fisher
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Re: Might be some silly questions

Postby Alison Fisher » Fri 13 Jun 2008 1:58 am

Hi Amer :D

One of my grafts is 16 years old, the other 12, and they are both still going strong. It often feels like I never get the same answer twice to any questions I have asked my doctors over the years but the general overall thought seems to be that the older a graft gets the less likely it is to reject. I have never been given any indication as to how long they might last, but like I said, they are still going strong so I am very happy I had them both done.

I can't comment about how long after the op you'd be able to go back to working out as it wasn't something I was doing at the times of my ops. My younger daughter was six months old at the time of the first op and I remember not being allowed to bend over and lift her out of her cot which made for interesting times. I wasn't allowed to bend forward to wash my hair either. Such restrictions didn't last long thank goodness. During the months of healing/recovery I just remember listening to what my eyes were telling me, and believe me if they weren't happy they weren't slow at letting me know. :lol:

Good luck with your op and I hope it turns out to be as successful for you as mine have for me. :D
grafts in 1992 and 1996


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