Recovery time after DALK?

[Shelley]

Hi all, I have been a member for years, but not posted since around 2003!

Anyway, I saw Mr Daya on Tuesday at Centre for Sight and he has said I don't actually have KC, which was diagnosed when I was 14, but rather Pellucid Marginal Degeneration.

Unfortunately my left eye is so bad I need a corneal graft urgently as I am on the verge of developing hydrops (good thing I saw him when I did), so he has written to my GP and is referring me down to East Grinstead for NHS treatment.

However, work wants to know how long I'll be off work for, and more importantly, how long before I can drive as I am a community based healthcare assistant for the NHS and really need to be independent in my role. At the moment I have no idea and I know everyone is different, but if anyone here has had DALK I would be grateful to know what your recovery time was like to get a rough idea to quote to my manager (even if it's "Everyone's different!").

Of course if recovery is slow but I am otherwise fit to work they have to accommodate me and occupational health would have to find duties I can do. Silly really that my main concern is working, when I should be thinking more about how I will get my son around (I am a single parent), but if things need to move as quickly as Mr Daya says then I really want to get things sorted in my head so I can relax and minimise my stress!

Thanks in advance,

Shelley

[Andrew MacLean]

Shelley

Welcome to the forum. You ask some difficult questions, but here goes with my take on the answers:

Whether you will be able to drive after your operation will depend to an extent on how good the sight is in your other eye.

I reckon that four to six weeks is probably prudent. Few surgeons like patients to return to work until after their first clinic post op.

Be prepared for a long recovery. It may be over a year before the sutures come out. That said, you can anticipate good vision once everything has settled down.

Every good wish

Andrew

[Anne Klepacz]

Hello Shelley
Well, the answer is 'everyone is different'. Some people find their vision improving within 3 to 6 months of a graft, for others it can be a year or more. And, as Andrew says, it isn't until after the sutures come out that you'll know what the final effect of the graft will be. Though of course, that doesn't stop you working during that time. As for driving, as Andrew says, it depends whether you're already effectively only using your 'good' eye for driving. If so, it won't be much different after the op. But it's good that your employer is thinking about alternative duties for you if driving does turn out to be a problem. Have you found the leaflets on KC and work that you can download from the home page?
www.keratoconus-group.org.uk/sitev3/publications
All the very best for the op.
Anne

[rosemary johnson]

Hi.
I was told to reckon on 2 weeks off work, and no heavy lifting, or pushing/pulling, for at least 6 eeks.
That doesn't include driving... have never been able to drive, so not applicable.
As others have said, depends on how well you can see to drive out of the other eye.
Also: is it possible to get some funding to emply a "PA" to drive ou about for a few weeks?? - maybe under access to work or similar?? (anyone know about this?)
The main problem stopping going back to work too soon would be if you have a general anaesthetic for the op and are still too woozy from the anaesthetic.
Having said all that.....
"urgent need for a graft because you are in danger of developing a hyrops"????
- you haven't actually got a hydrops at the moment, ahve you???
This all sounds like a piece of hyper-reaction, just a tad!
I've had 4 hydrops before my graft (and I think 2 more little ones since).
And lived to tell the tale. None of them t all connected with going for the (as it happens, disastrous) graft.
Hydrops can be a nuisance, and some people find one apainful for a while (mine weren't much to bother about), but they aren't the end of the world.
At one point in history, they used to try to induce hydrops in peple with KC, because the post-hydrops scarring actually tends to stiffen the cornea, thus slowing the progression of the KC (like a like a prototype CXL.
Are yo really sure you want to do this?? - it's a long-haul recovery process, very few people end up with vision good enough not to need contacts/glasses/both, and once you have a graft, you can never undo it (believe me, I've tried).
Good luck with it all, whatever way ou go.
Rosemary

[Shelley]

I'm going to resurrect this post after all this time, just to share what my experience has been.

I got referred on to QVH at East Grinstead, under the care of Mr Lake, who rediagnosed me with Keratoglobus. Unlike Mr Daya he did not want to graft immediately and refuted Mr Day's claim it was urgent. Difference between NHS and private, eh? However, CXL is not an option for KG and I couldn't tolerate contacts. I did end up having an episode of hydrops, but i got over it ok. Because of other issues I have I also suffered with entropion so prior to grafting I needed plastic surgery to tighten my left eyelid.

After 14 months, my left eye underwent DALK in January 2012. It didn't go well and I needed a further 2 surgeries to try and correct it. In the end they converted it to a PK in march 2012.

Since then, as it is a large sized graft I have had 4 rejection episodes. All reversed with IV steroid treatment, but I've now been on cyclosporin for the past year which has helped settle things.

My left eye is now at 6/12, with a cataract which has developed following steroid treatment, corrected to 6/9.5 with glasses. I'm just waiting for my eye to be calm for a full 6 months before it is treated. My right eye is 6/38, corrected to 6/12 with glasses. Recently my right eye seems to have distorted a little more, and the pressure has dropped to 6, but I won't have another topography scan done until my next appt in September. My consultant says CXL is still not an option for KG, but hopes that flashlinking will be shown to be effective and approved by the NHS as it can be performed on much thinner corneas (my right eye is currently 200 microns at its thinnest). Anything to hold off a second graft for now!

All told I was off work for 4 months because of complications and multiple surgeries. I'd changed jobs before my graft came about, but it still wasn't ideal. But I am very glad my left eye and vision has improved and hope it will be further improved when the cataract is removed and an artificial lens put in, and the remaining stitches, which will be removed at the same time.

Thanks for the advice before, I didn't really understand much back then at all!

[kieran19685]

I have an appointment in three weeks to discuss a graft on my left eye!

Overall would you say it's been worth it?

I can't tolerate a lens on my bad eye