UK Keratoconus Self-Help and Support Association

Hi all,

Many of the old-timers on here will know that I used to have lots of problems with the full-thickness graft in my right eye. Well, those troubles are now over, it seems... but I'm now wondering about my DALK-using-freeze-fried-cornea in my left.

Not that it is rejecting, because I understand that by using freeze-dried tissue, the eye has nothing to reject.

However, here goes...

Just before the wedding, Claire suggested that I replace my specs lenses with clear ones, rather than photochromic ones which would show up black in all the photos. I did this, and because my consultant had previously commented that my left lens could be improved, I got the new prescription.

The new left lens was a much lesser prescription than previously, and wonder-of-wonders, I could see through it... getting about 6/15 rather than the big blur I'd had before. Happy John

During the honeymoon though, I noticed that I was having driving difficulties - not being able to easily see from the left-hand mirror, and I soon reaslised that my left eye's vision was much worse than before. It's as if I'm looking through a vaseline-coated spec lens, but it's as clean as clean can be. Blinking doesn't seem to change everything, although some days are less worrysome than others.

I've got an appointment next week to see my optom to check things out, but in the meantime, has anyone else experienced this?

All the best

John, what you describe is outwith my experience, but all the best with your optometrist appointment.

Andrew

John, hate to say this, but I think you should get to hospital and get it seen.
I don't know why freeze-drying a donor cornea should make a rejection impossible - a DLAK is less prone to rejection than a PK, but so far as I know, it is possible to have a reaction "rejecting" even inert tissue.
Not that I'm saying that's what it might be.....
Hope it turns out to be someone simply and quickly fixed, anyway, and good luck.
Rosemary

Thanks for the suggestion, Rosemary. My understanding is that with this particular technique (which is very rare - only one surgeon in the UK is licensed for it), a freeze-dried stroma was grafted in to my cornea, which was then covered with my own cells for a top and bottom layer. Thus, no white blood cells could get to the foreign matter and rejection wasn't possible.

You're right of course that DALK grafting does only significantly reduce the chance of rejection; but I was told that the use of a freeze-dried stroma reduces it to zero.

Am certainly getting it checked out though; just to be safe.

Gosh! - not even a partial-thickness greaft but a "jam in the sandwich" layer graft. Wow.
HOpe you sort the problem out, anyway.
Rosemary

Okay Rosemary, I like your "Jam in the sandwich" metaphor

It felt like a challenge: can anyone come up with a better metaphor than Rosemary"s?

Here's my try: 'Jam (sorry it's jam again) in the doughnut". The new stroma in John's eye doesn't squidge out of the edges of his reconstructed cornea like jam from a sandwich, but is contained completely by his own endo/epithelial cells.

Andrew

...or maybe not ;(

Well, I saw my optom on Thursday, and he didn't like what he saw. In four weeks, my left eye's best corrected acuity had reduced from 6/9 to 6/36. He asked me to attend the local eye casualty unit. He said that it could be a rejection, but was more likely to be an infection, probably viral, or maybe acanthamoeba.

The local eye unit was closed, and rather than be seen by the regular A&E on-call opthalmologist, I was advised to make my way to Moorfields.

Several hours later (though I've seen Moorfields' A&E in much worse states), I was seen by a doctor. She diagnosed a rejecion in my DALK (left) eye, and put me on hourly dexamethasone (steroid) drops and chloramphenicol (antibiotic) drops 4 times a day.

I'm now waiting until Friday to see my consultant to get to the bottom of this.

Of course, my history of taking Dexamethasone isn't good. It's caused me to have very high eye pressure before, and the timoptol I was prescribed to counter that gave me (permanent) asthma; so I'm sure that further medication will be needed on Friday.

Ho hum, will keep you all informed.

john! A DALK rejecting is the worst kind of rotten luck.

All the best

Andrew

It certainly is, Andrew

That's the reason I went with a DALK in the first place - in an attempt to avoid the 9 rejection episodes I experienced in the right eye.

John Smith wrote:It certainly is, Andrew

That's the reason I went with a DALK in the first place - in an attempt to avoid the 9 rejection episodes I experienced in the right eye.

9 rejection episodes in the right eye - crikey plus the current rejection episode in your left eye. I do not envy you. I thought my eyes didnt like anything in them, your eyes definantly dont.

Posts like yours make me remember that i am lucky with my KC at the moment.

Sorry to hear of your problems, hope the drops/medicine doesnt cause too many more problems.