Astigmatism after graft

[craigthornton]

If you've seen my other thread you'll know I had to have my graft re-stitched due to a self-inflicted blow to the eye.

I seem to have bad astigmatism and don't remember it being this bad after the initial graft.

Does it settle down over the next few weeks as the graft starts to knit with the eye?

[Asif]

craig

because your graft split as the lens fell out i'm thinking it may have been restitched? If it did or didnt the surface/shape of the cornea will have changed therefore astigmatism may also get worse. It should settle down after a while, if not your ophthalmologist will start to remove stitches to try and reduce the astigmatism. How long has it been since your graft?

with regards to your previous post about your lens....aphakic people are ones without/lack of a lens. They are more likey to develop post vitreous detachment and retinal detachment. As well as not having a lens you will not be able to accomodate so near tasks will be difficult. You may end up having to wear reading glasses or even bi/vari focals. If I were you I would have a word with your head consultant and not a registra, which is what happens to me sometimes, and explain to him/her what are the risks of you not having a lens short and long term and would you benefit from a IOL or something similar.

[Fauz]

Hi Craig,

I'm really sorry to hear what you've been through post graft. To introduce myself, I've been lurking on this forum for a while. I don't have KC but another corneal dystrophy, I'm on my 5 graft, I have the dystrophy in both eyes (first grafts at 7 (both eyes) then 12, 15 and the last one was at 33, my disease re-occurs in my grafts) and I've found this forum a really, really useful source of personal cornea transplant stories. It's always good to know I'm not alone!

Anyhow, I've emerged from the shadows because I've had a similar experience to you and at this point, resuturing of a cornea graft, I bet there can't be many others with that experience. Our experiences don't match quite, I didn't knock my lens out! But I did have my graft resutured. In between grafts I have laser surgery to keep my disease at bay (I won't go into detail) and the last time I had laser surgery my graft gave way. Immense pain, fluid leaking out and I eventually ended up in A&E. There are several reasons why this happened, but I've had laser surgery before numerous times and I'd have it again since it reduces the number of grafts I have to have.

To cut a very long story short, after they resutured my graft, the world looked rather dali-esque, quite distorted and this was down to the excessive astigmatism I was left with. I think ultimately, they can't do as perfect a job when resuturing compared to what they do when they first carry out a transplant. The resuturing is needed to seal the eye back up again, which is more important than giving you perfect vision, and increased astigmatism is probably inevitable. The way I picture it, it's like trying to mend a rip in fabric, you need to pull the torn material over a bit and that's bound to leave some distortion. I think you have to let it settle down, it's bound to be inflammed and feeling a bit abused and so take things easy and see how things are in a month or so.

Eventually the extreme astigmatism I was left with and the trauma (my endothelium was failing as well) meant that I needed another transplant, done in Jan 2006, and everything seems to be going OK. I hope your new cornea recovers and that glasses or contact lenses can correct the astigmatism you are left with. It will take time though so please be patient.

Anyhow, hello to you all!
Fauz

[Asif]

Fauz,

do you have keratoglobus?

[Fauz]

Hi Asif,

No. I have granular dystrophy of the cornea. Crystalline deposits build up in my cornea until eventually it gets quite hard to see out! I have quite a severe "version" of this disease.

Fauz

[craigthornton]

craig

because your graft split as the lens fell out i'm thinking it may have been restitched? If it did or didnt the surface/shape of the cornea will have changed therefore astigmatism may also get worse. It should settle down after a while, if not your ophthalmologist will start to remove stitches to try and reduce the astigmatism. How long has it been since your graft?

with regards to your previous post about your lens....aphakic people are ones without/lack of a lens. They are more likey to develop post vitreous detachment and retinal detachment. As well as not having a lens you will not be able to accomodate so near tasks will be difficult. You may end up having to wear reading glasses or even bi/vari focals. If I were you I would have a word with your head consultant and not a registra, which is what happens to me sometimes, and explain to him/her what are the risks of you not having a lens short and long term and would you benefit from a IOL or something similar.

Is vitreous part of the back of the eye? When I was examined the day after my re-graft, the surgeon said he was pleasantly surprised as he expected matter at the back of my eye to have come forward.

They said I had not experienced retinal detachment, but I am NEVER going to left anything remotely heavy for the rest of my life.

[Asif]

yep vitreous is the jelly like fluid and the back of the eye between the retina and lens, and aqueous humour is at the front between the cornea and the lens. The water that gushed out your eye may have been the aqueous. You wouldnt have got PVD or RD yet but you may be more at risk when you are older if you are aphakic. May be worth talking to your consultant about it.

[craigthornton]

That might explain the swirling I saw for the first few days after the incident (was a bit like looking through a lava lamp!)

That has cleared now though in low light I experience a fluttering out of the corner of my visison.