Here we go again

[John Smith]

Well, I saw my consultant again today, and she's confirmed that my vision is far worse now than it was with the old lenses in my glasses .

So I have to make another apppointment to get my specs changed.

Discussion then turned towards making some long-term improvements. We're talking about "refractive surgery" on the right eye - which is non-guaranteed, but which "might" help, but would be more likely to make an improvement than worsen things, but may just be different.

Finally, conversation turned to my other, very keratoconic eye. And we talked about the possibility of a graft, lamellar this time rather than penetrating, to reduce the rejection risk.

I'm going to be referred to a Mr. Rostram, as my current consultant doesn't carry out either procedure.

Is a lamellar graft the same as DALK? I thought it was, but the consultant did confuse me slightly referring to a similar, much newer, technique that I may be suitable for.

And also, if anyone has been under Mr. Rostram's knife, can they PM their opinions to me please?

Oh well. Out of the frying pan...

[GarethB]

John,

I know it is very slow for you at the moment, but let us hope it will be worth it in the end.

Regards

Gareth

[Louise Pembroke]

Get as much info as possible John

[Sweet]

John i kinda think it is as DALK does stand for deep anterior lamellar keratoplasty so isn't that the same??

I do understand that rejection rates are much lower though which is why i was happy to have one done as well.

Hoping that you get this all sorted soon. Sorry but i can't help you as to consultants, this is very sad but i have only seen mine in Moorfields once and i have no dam idea who he was! Maybe i need to phone them up again and say that as it has been over a year can i please have a check up.

Take care, Sweet X x X

[jayuk]

John

Yes, Lamellar is the same as DALK.

Are they thinking of creating wedges in your grafted cornea?...thats the only thing I can think of that they could do......

Its def worth thinking of gng the DALK route....I think Knights dialry and pics, etc will be valuable for alot of us, inc me so def a good idea to see how his recovery goes.

J

[John Smith]

Jay,

I've got no idea what would be considered yet, other than I've got to go to Tooting of all places to meet the consultant and find out what he recommends.

I think my consultant would have been happy to do another penetrating graft for the left eye, but seemed very pleased about my initial suggestion of DALK to significantly reduce the chance of rejection - as I've already had so many episodes in the right eye.

I certainly look forward to reading Knight's diary. It just shows how the knowledge gained from the forum can make such a personal difference. First sclerals, and now this!

[jayuk]

Totally agree!

I know its a pain, but sometimes, its soo valuable to keep these detailed logs, as Gareth, myself and now Knight have demonstrated.....to me if it helps ONE person than its done the job!

I would suspect from what you have said; that they may have been thinking of performaing a corneal wedge resection...unless of course they were alluding to another PK!

J

[John Smith]

Jay,

I've not heard of a wedge resection, what exactly is that?

Also, I've just been doing a little editing for the Conference DVD and found a wonderful little bit in John Dart's talk, saying that DALK is indeed (as mentioned by Sweet) Deep Anterior Lamellar Keratoplasty, but that DALK is the "new thing" that my consultant may have been talking about, and that it was different from "traditional Lamellar grafts". Alas, he didn't mention what the differences were.

All a little confusing, but hopefully things will be more clear soon.

I've now got another appointment at the opticians sorted out, and there's hope that I can return to work if I can see with new specs

[jayuk]

John

I also believe DALK is the better option. BUT, again its also a skill!...it requires a newly designed set of instruments and some serious skill on the Consultants part. Be very dilligent if you are being offered a DALK as not all can do it. You will also find that there are many consulants that are doing this, or making the procedure available but caveat it around "although we may need to turn to a Full PK during the procedure"........the skillful part if actually disecting the corneal layers; both from the corneal transplanted tisse and the host...

Also, few things to bear in mind, is that once its done it may initially take a while to get vision back....so rather then wake up the next day and be able to see your hand abit more clearly..as I could after my PK, the DALK may take slightly longer and the grafted cornea and layers take a short wile to flatten out and cushion onto your own back layers of the cornea....

J

[Lisa Nixon]

John - not sure about the technical bits, but I had endless problems when first eye was grafted and absolutely dreaded getting this eye done - seriously depressed and terrified. I need not have worried it's been brilliant. I'm sure your 2nd eye will be fine, the odds of the same things happening again must be minute and I'm sure they'll sort out the one that is currently giving you the problems. Thinking of you. Tubs