UK Keratoconus Self-Help and Support Association

In 2000 i had a corneal trasplant in my right eye. I believe the procedure was penetrating keratoplastic since the partial removal of the cornea was not yet known then.
The thing is, every now and then i feel very dry, sore and irritated in my transplanted eye. This is never the case with my "Non surgical eye" although I have KC in both eyes and has better vision with my eye that has a transplant. Is this normal?

Fot those of you that have read my previous posts i had CXL in my other eye, vision has become a lot worse than preop The doctor that did the cxl suggests corneal transplant although he does not know why my vision has become that much worse.It is now a year post op the cxl and the vision is very bad. Is there hope for waiting some more time or should i go for the transplant? Feels kind of bad since the cxl was to made to keep out surgery in the first place..

if you have pain in a transplanted eye best to get it checked out asap as could be a sign of impending rejection and or infection.
x

Hi Grim

First, what you describe is probably due to drying. This can be the case post graft and may be helped by using comfort drops regularly.

I also apologise for not getting back to you on another thread after I asked questions about your CXL eye.

My thoughts are that before you think of a graft in the CXL eye you should consider contact lenses again.When you say that you could never wear contact lenses, what options did you try?

Although your ophthalmologist may not be able to work out why you cannot see, that does not mean there is no reason for it. I can think of quire a few reasons why this could have happened but again, without more technical information, this is only speculation and to be honest, your ophthalmologist may have already looked at those possibilities. However, it does seem like there is a bit of a lack of communication here and I would echo Anne's previous advice about getting a second opinion as well as looking at other contact lens options. If comfort was an option. there are specialist soft contact lenses and scleral lenses that address this issue.

Just to give you an idea of what could be the issue, you need to understand that your vision relies on light passing through FOUR optical surfaces.Have a look at the diagram here

There is the front and back surface of the cornea and the front and back surface of the lens of the eye. For good vision, all of these surfaces have to "work together" like the lenses in a telescope or microscope. If one of them is distorted, then the image reaching the retina at the back of the eye is distorted.

Now, in keratoconus, its often the BACK surface of the cornea that is more distorted than the front (look at these pictures on my website).

In some eyes, if keratoconus develops slowly over time and at an early age, then some of the various surfaces of the lens and cornea tend to grow to compensate for distortion in the others. This then gives better vision. When you put one of the surfaces right by way of surgery or contact lenses, then the whole system is thrown off.

This has happened to older people, for example, who have implants after cataract removal. They have good vision before the op and then it all goes wrong after the implant. I know of cases where when this happened, and topography was done after the event, it was found that these 80 year olds had previously undiagnosed KC to which their visual system had simply adapted.

So, it could be that after CXL, your cornea did improve in shape but in the process went out of sync with the lens inside your eye. It might be possible to correct this with contact lenses - but out find out, I think you need to consult some other people, as your current doctor is not really getting to the bottom of the issue.

What I would say, is do not go to graft before you have searched for other answers, as you may end up in exactly the same situation.

Additionally, as I have said before, you are not going to find specific answers HERE. Your situation needs proper investigation using the relevant technology. It also has to be realised that no ONE person has ALL the answers to a particular condition or disease, much though we all like to hope that.

Lynn