when to graft the other eye?

[sarah.w]

Hi its been a while since i have been on here so hope everyone is well!

I have been wearing my sclerals for about 4 years now and i have been very lucky in that i can lead a pretty much normal life. I had my left eye grafted about 6 years ago now and the vision with a scleral in this eye is really good. Unfortunately my right eye which has not been grafted seems to cloud/haze over really quickly so the vision is not great and seems to be getting worse. When i asked my optometrist he said it is because there is a scratch on the right lens of the eye so obviously sclerals will not help with this.

My vision in both eyes without lenses is pretty much a sea of blur and colour, so sclerals are my lifeline. I was just wondering your opinions were on me getting my right eye grafted? Is it worth going through another graft? I’m thinking that if i did;
1. My vision may be clearer with a scleral as the scratch would be removed from the lens of the right eye and
2. There may be a small chance i could wear glasses for that eye just for when i get up/ go to bed which would make such a difference to my life
I know from experience of having the left eye grafted that this may not happen as the cornea may return to its original shape but sometimes it’s a risk you may have to take.
Any advice would be greatly appreciated
Best wishes
Sarah 

[GarethB]

Hi Sarah,

I might be being thick but I am slightly confused by the scratch on your lens, do you mean scratch on thee scleral lens or scratch on cornea or scratch on the lens in the eye behind the iris?

The things I considered when I had both my grafts were what do I have to loose by having the grfat and what might I gain from the graft.

By comparing the two lists in both cases a graft won hands down and over 20 years on are working fine.

You know what a graft involves having had one done and so aware that you may still require glasses or contact lenses or you might even end up like I did for a while and not need any vision correction for quite a few years.

If you KC is relatively stable and you are coping fine then you have time to think about this without rushing into something you are unsure of.

Regards

[sarah.w]

Sorry Gareth i did'nt explain that properly there is a scratch on the cornea of the right eye not the lens behind the iris! I think you are absolutly right, despite my left eye not being the shape they wanted it to be post graft the vision i am able to get with a scleral in this eye is great and has enabled me to drive and study physio at uni.
Thanks for your advice

[rosemary johnson]

Sarah,
te first questions I'd like to ask, in your shoes, would be things like: what sort of scratch on my right eye? How did it get scratched? Can anythign be done to help it heal - or will it heal better given a bit of time?
Maybe you've asked all those already, and aren't encouraged.
Bottom line is, it will depend how well you can get on with one good eye, and how much hassle it is to you to have a big difference between the eyes. And, particularly if driving is pimportant to you, how much having poorer vision in one eye may affect your field of vision - particularly the right eye which is closer to the traffic coming up behind. The last hting you want is to have an accident because your field of view is no longer a wide as you think it is.
YOu know abut the procedures and disruption caused by a graft. I gather than 2nd grafts can be more difficult than first ones - your immune system is more used to having foreign tissue imported and may be more ready to "repel boarders" - so not only may the new graft be more likely to reject, but the first one might get rejected too. YOu might also be more sensitive to the drugs used.
Rosemary

[Andrew MacLean]

We all know that this is a difficult decision for you, and others have already sketched the sort of response that I'd have made to your initial enquiry.

The important thing is that you remember that it is your eye and the decision belongs to you alone. All the best.

Andrew

[sarah.w]

The scratch on my right eye is on the cornea, im not sure how it got there but there is nothing they can do for this as far as i am aware. This is a question i was thinking of asking my surgeon...would it be possible to carry out a procedure such as laser surgery depending on the depth and size of the scratch? Or would this weaken the thinned cornea even more?

The graft would be on my right eye which has not been grafted before, therefore i would hope that my body would be more tolerant of a foreign body. Despite the shape of the graft not being exactly what surgeons wanted on my left eye they were very happy with the graft itself as it healed so well.

I know its a big decison to make but i would like to be able to get the most out of life as im a keen traveller and very ambitious so i was thinking sooner rather than later so i can give my eyes the best possible chance!

Thanks so much for your advice
sarah

[Andrew MacLean]

Sarah

All the best; a scratched cornea can really make sight difficult, in the end it may just be that the graft is the better option.

Andrew