A strange new twist / graft

[Michael P]

Matthew, I am glad that you have such positive news and look forward to hearing how things pan out.

[Asif]

Matthew,

I was in the exact same situation before I had my graft. I went through so many lenses and wasnt able to wear them for 5 consecutive days for at least 8-10 hours, If I did than my eyes would feel sore for the next 3-4 days. My left eye was a lot worse regarding vision and tolerance to lenses.

As I need decent vision for what I do I had to get something done as lenses wasnt working for me so I had a graft 2 years ago. My vision has improved to about 6/36 and VAs 6/9-6/6 with glasses. However my vision is not stable and fluctuates greatly everyday, some days my vsion is better without glasses. Reason mainly being that I had all 16 sutures in place, my consultant was reluctant to remove any as my astigmatism was 3 dioptres and didnt want to risk making it worse. I broke a stitch yesterday and had it removed and now my vision is a lot worse and now I cant even read just becuase i had one stitch taken out.

I have previously spoken to my consultant about getting stable vision in my grafted eye and reccomended rgps.

I would only recommend you having a graft if its a last resort, as its likely you'll have to wear glasses/rgps after. You'd be very lucky if you have to wear neither.

[Matthew_]

Asif,
That's very interesting. Sounds a bit rough! Is it normal to leave the sutures in? Does the graft not connect to the surrounding tissue after a while?
I think the stability bit is definitely worrying. That said, 6/36 if it was stable would be great I am currently 6/60> in left eye. If I cover my right eye whilst not wearing lenses, I find it dificult just to place my feet accurately on the ground. So I am not sure I have anything to loose on that eye. I am more cautious about my right eye which 6/36 anyway and is pretty good. I am not expecting to get rid of lenses or glasses. In fact I dream of the days when I could simply slip on a pair of glasses to drive or watch TV! Does a graft make lens use easier, I thought that was one possible benefit? Of course, nothing is guaranteed and I understand that in some cases (a small minority) vision could be worse. I am not sure it could be much worse on the left eye though.
Many thanks, really helpful info.

[Asif]

Before one is removed, unless it has broken, a topography of the eye is done and stitches are removied in the area where the cornea is steepest, to help flatten it. When this is done there is a possiblilty it can affect your vision either by improving it or making it worse. If a tisch is taken out in the wrong meridian, where my stitch was broken, it will likely make your vision worse. I spoke with my consultant a few months ago and asked him what could be done about my fluctuating vision as i needed it to be stabalised. He said that he did not want to risk taking any stitches out as my astigmatism was 3 dioptres and could be made worse. He would only recommend taking out stiches with astigmatism of 5-8 dioptres or greater. He then said that if i wanted stable vision he recommended i wear an rgp lens. I have an appointment with him next week to discuss what to do next since I have two broken stiched and one of them were removed.

My situation was similar to yours before I had my graft in my left eye, my right is currently ungrafted and i try my best to wear lenses. My vision in the left pre-graft was at finger counting stage, some letters I could guess at 1/60. This eye was a lot more intolerant to lenses. I'm now at the same situation with my right eye and contemplating whether to have a graft or not as things are not going as hoped with my grafted eye as its been over two years and have not got stable vision from it, and I'm currently relying on wearing a lens in my right eye for daily vision(or whatever days i do get) so dont want to graft that yet..

[Matthew_]

That does sound very similar to me. I got to the finger counting stage too, I had an eye-sight test last Monday. I got the finger counting question wrong! I'm not sure what va standard that makes me? Obviously no Hawk-Eye! I might have to retire from the Archery Club! (I fear lives will be lost!)
I too depend on my right eye. Thanks for the information on the stitches, that's very interesting. I will certainly bear this in mind. At least I am considering options beyond just lenses, which are clearly not working for me.
Thank you for all your help.

[Matthew_]

Update:
I went to see an opthomologist at Gartnavel with the graft recommendation letter in my hand. I had just finished a treatment of pred forte (predisalone?, steroids anyway) with no benefit. She seemed to think a graft was a possibility but I have to wait for the consultant (who was on leave), we made an appointment to discuss. Before I had a chance to do this, I had a follow up at the lens clinic. The truly wonderful optom there took a good look. She (like me) feels we tried everything with the rgps. I trialled kerasoft lenses, which were far more comfortable. One of the big issues with rgp is that my eye-lids are very sensitive also, so they get very red and angry. I have a load of infections and cists as a result and I am now the only person I know with cauliflower eyes! (aswell as cauliflowers ears; but that was rugby!). The kerasoft lenses were very nice to me eyelids However, the optom noticed that I still had an allergic reaction albeit somewhat muted compared with previously. She feels the kerasoft lenses will be a good palliative but there is little else she can do.
Before I got a chance to see the consultant, I got a letter through the door, telling me I am down for an op in November at the eye hospital. Strangely enough, it doesn't say what the op is!! But since we have only discussed a graft for the left eye, it must be reasonable to assume that this what the op is! I am really pleased. I have researched all the pros and cons and I am sure this the right course of action for me. It also saves me going down to Birmingham for it, which would have been more difficult, logistically.
So I'm sorry Gareth, we'll have to have that drink another time. But I do have family down there, so I am due a visit!
I am so chuffed that it is going to be so soon. Hopefully November will be nice and grey this year, could help with the light sensitivity!!!

[Pat A]

Hi Matthew
That's really good news - really pleased for you.

But I would just check with them what op they are proposing to ...........the NHS is pretty good but have been known to make the odd mistake here and there - and I don't think you've suggested you need a cataract op have you..... ? !

[Michael P]

Matthew, I am pleased to hear that you now have a graft date and it seems the decision has been made for you!

Out of curiosity has anyone suggested piggybacking? I have recently begun to have a problem with rgp's but piggybacking has been great for me and gives me long wear time. Of course, if you have problems with your eyelids I suppose this may still not help.

[Andrew MacLean]

Well done, Matthew. This does show the advantage of having the Optometrist and Ophthalmologist working as part of the same integrated team.

All the best for your appointment ahead of surgery.

They do a wonderful thing in Gartnavel. Once you have been admitted and you are wearing your theatre gown (a flimsy garment), the porter comes to wheel you to the elevator and thence to the operating theatre. As you leave the ward they will hand you a very large box that has large blue friendly letters that spell out the legend

Human tissue for transplant

This is your new cornea; you get to carry it into the theatre. I don't think they give you back your old one.

Every good wish.

Andrew

[GarethB]

Matthew,

Sure Andrew will buy the drink for you as you will be closer to home.