UK Keratoconus Self-Help and Support Association

hi am new to forum and would just like to ask has any one had a cornea transplant? i have see quack twice before and told thay still think im to young at 35 as i will prob still have to wear lenses after. but the daily pain is getting to be to much. do i push for it?

Hello and welcome to the forum.

I was offered my first transplant when I was about your age, but I waited another twenty years before I had surgery. Others on the forum have had transplant surgery when much younger than you are.

The guiding principle for most consultants is not the age of the patient, but the clinical indicators that the patient presents. It may be that there is still a great deal of mileage for you in contact lens wear, but if you are experiencing discomfort or pain with your current lenses, perhaps you ought to be trying either a different style of lens or lenses made from different materials.

There are Scleral Lenses, Hybrids, Soft lenses for keratoconus, piggy back lenses and the usual Rigid Gas Permeable which themselves come in a range of styles. Perhaps your ophthalmologist is suggesting that you could avoid surgery at this stage by exploring the options that lenses offer?

Every good wish.

Andrew

As Andrew says, try different lens options first because surgery is a one way street. Once done there is no reversing it.

The aim of the transplant is to create a more regular corneal surface to make vision correction easier. Therefore there is still a good chance that you will still need contact lenses despite a good number of people only needing glasses.

I have come across many people who were told they had no choice but to have a transplant but they insisted on trying a different lens type; most I have come across have moved to soft lenses for KC. They have vound the vision to be comparable if not better than RGP lenses, increased comfort and wear times and avoided the operating table.

The lens choices are far better than they were more than 20 years ago when I had my transplants. By todays standards my transplants when I was 18 would be unnecessary now just because of the wide range of lens and surgical options available now.

I wear the soft lenses for KC after my RGP's became really uncomforatble (I could only wear them for an hour per day a few days at a time), now I am completly unaware that I wear lenses such is the comfort and the level of vision means that I can do anything a normally sighted person can do.

Recovery period for a graft is at least 12 months so an option that should only really be taken as an absolute last resort.

thank you for your replys. i must admit after a long night of searching i now have a lot more info about different lenses. I am due back at hospital next thursday, so will push harder for hybrids or piggy backs and see what happens.T o be totally honest, its probably as much my own fault for getting up munching painkillers coming home munching more instead of being more pushy with the hospital!

I had a graft 18 months ago because I was in so much pain. As the other guys said I tried different lenses but in the end I just needed a resolution. I was going to work and coming home and going straight to bed. In my own mind I knew it was time to have the graft, I was 48 at the time.

I can read fairly well unaided but need correction for anything more than that. It does mean that I can wear glasses for pottering about which is a god send in the mornings. I am waiting for a contact lens. I went to the clinic on Wednesday and a off the shelve soft lens gives good correction. They however need the consultant to sign it off because there is an increased risk of infection (apparently).

It's not been plain sailing as I react to the steroids so I am on two types of drops to keep the pressure down. This does mean however that I have had to make frequent trips to the hospital to have the pressure checked. Fortunatly I have a very understanding employer.

You'll know in you own mind when the time is right. I paid to see the consultant privately in the end (£150). Not so I could push for it but so I could get some quality time with him and ask loads of questions. It also ment we could see him in the evening so it was easier for the wife to attend and ask questions as well. I know you shouldn't have to pay but that a forum topic in its self. I just knew it was a one way street so wanted to make sure I had covered all the bases.

All the best
Ian

With respect to KC and soft lenses the risk of infection due to soft lenses is no different to RGP lenses. This is simply because for most of us, using lenses is the only option so we take more care of them and observe better hygiene when taking lenses out and putting them in.

An eye clinic in a hospital in Sunderland did a study in to eye infections and did find most were due to contact lens wear and were from soft lenses. However when analysing the data further, the presenter did sya that about 90% were from people who wore lenses for vanity reasons. Causes for infection were down to improper lens storage, sleeping with the lenses in, taking lenses out and cleaning them with their own spit before putting them in and so on.

I have never had an eye infection when wearing RGP lenses and now having worn soft lenses for 4 years now and no eye infection. If I break this down to hours for each lens type, a soft lens has been in my eyes for about three times longer than RGP lenses.

In my opinion when it comes to increased risk of eye infections due to soft lenes for KC, this is a complete myth.

Does KC ever come back in a grafted eye, or is this rare?

This is extremely rare, especially with the topography machines which had yet to be invented when I had my grafts over 20 years ago. A few years a go I asked consultants that a met at different KC Group conferences, AGM's and workshops for optomotrists and opthalmologists how many years expereince they had and how many cases they had encountered where KC had rerurned in a grafted eye.

If I recall correctly the sum of 8 consultsnts expereince who had encountered KC returning was in the region of 200 years combined experience and no more than a dozens patients could be recalled where KC had returned. When pushed, KC had returned in the host cornea and never the donor cornea.

So as you will see, this is extremely rare.