Corneal Oversensitivity following transplant

[eitleog]

My son had a corneal transplant for a left-eye keratoconus hydrop. His specially ground lenses hurt his eye so much, however, even with corticosteroid drops, that he can only tolerate the contact lens on his left eye for 5 or 6 hours, then the eye becomes inflammed and he can't use the eye for 3 days. Unfortunately, also, the drops make him quite sick and his weight drops considerably from the loss of appetite they bring on. Are there other non-corticosteroids that people have used successfully to reduce corneal sensitivity to lens use, or some way to float the lenses off the surface of the cornea or distribute the weight ? Thanks.

[eitleog]

Re: Corneal Oversensitivity following transplant

rosemary johnson » Sun 07 Jun, 2009 04:16
Hallo, and sorry to hear of your son's problems.
How long is it since he had his graft? - is it possible that sensitivity may reduce as the eye "settles down" more, with more time elapsed since the operation?
He had his graft 4 years ago now so it’s unlikely it’ll settle down.

As regards drops - I don't know what non-steroid alternatives there are, but would be interested to hear what you find out, as I too have very nasty reactions to steroids.
I’ll keep searching.

As regards lenses - is he wearing the standard corneal lenses? - hard, about 8mm diameter, probably made of a variety of rigid gas permeable polymer?
Oh boy, the Research Department at the Eye Institute here in Montreal does magic analyzing his eye changes (like the cratered moon) so they can send
the Specs down to Chicago. My son considers me a dummy compared to these specialists, but they don’t have all the answers yet. I think they’re hard
gas permeables though. They’re shaped to push down on the graft and make it hemispherical. The lens must be pushing down on the ends of the
nerves/scar tissue left by the operation.

If so, it could be worth enquiring about alternatives. There are quite a few alternative lens types now, and some may be more comfortable for him than others.
These range from special soft lenses (Kerasoft Irregular Cornea specialise in odd shaped eyes sucj as fitting over the "seam" resulting from a graft, ones with a hard centre and a soft skirt; sclerals, which look frighteningly huge but some of us find very comfortable as they arch clear right over the cornea itself and sit on the white outer part of the eye; and piggybacking, or wearing a hard lens over an unpowered soft lens that acts like a cushion.

Good suggestions. He’s been through the soft Rose ones he says. I thought a scleral type design, although ugly, might work and so,
suggested it to him, but so far, the Research center has been trying the specially ground ones, and they override what I say. He’s done the
piggybacking and soft lenses.

He may find one of these better than his current type.
Has he tried using different types of contact lens fluids? SOmetimes people develop allergies to som ebrands of the solutions, or to the preservatives used in them, and a change of solution does the trick.

Another good idea. I’ll see if I can insert that into his considerations, however, the coincidence between overwearing them and inflammation is
very great and may not be a problem of the eye solution.

Good luck to him. Hope you find the answer and get things sorted out soon.
Do keep us posted.
Rosemary
Thanks Rosemary. Looks like it was early morning when you typed. Get some sleep. Thanks again. Troy

[eitleog]

Re: Corneal Oversensitivity following transplant

rosemary johnson » Sun 07 Jun, 2009 04:16
Hallo, and sorry to hear of your son's problems.
How long is it since he had his graft? - is it possible that sensitivity may reduce as the eye "settles down" more, with more time elapsed since the operation?

He had his graft 4 years ago now so it’s unlikely it’ll settle down.

As regards drops - I don't know what non-steroid alternatives there are, but would be interested to hear what you find out, as i toohave very nasty reactions to steroids.
I’ll keep searching.

As regards lenses - is he wearing the standard corneal lenses? - hard, about 8mm diameter, probably made of a variety of rigid gas permeable polymer?

Oh boy, the Research Department at the Eye Institute here in Montreal does magic analyzing his eye changes (like the cratered moon) so they can send the Specs down to Chicago. My son considers me a dummy compared to these specialists, but they don’t have all the answers yet. I think they’re hard gas permeables. They’re shaped to push down on the graft and make it hemispherical. The lens must be pushing down on the ends of the nerves/scar tissue left by the operation.

If so, it could be worth enquiring about alternatives. There are quite a few alternative lens types now, and some may be more comfortable for him than others.
These range from special soft lenses (Kerasoft Irregular Cornea specialise in odd shaped eyes sucj as fitting over the "seam" resulting from a graft, ones with a hard centre and a soft skirt; sclerals, which look frighteningly huge but some of us find very comfortable as they arch clear right over the cornea itself and sit on the white outer part of the eye; and piggybacking, or wearing a hard lens over an unpowered soft lens that acts like a cushion.

Good suggestions. He’s been through the soft Rose ones he says. I thought a scleral type design, although ugly, might work and so, suggested it to him, but so far, the Research center has been trying the specially ground ones, and they override what I say. He’s done the piggybacking and soft lenses.

He may find one of these better than his current type.
Has he tried using different types of contact lens fluids? SOmetimes people develop allergies to som ebrands of the solutions, or to the preservatives used in them, and a change of solution does the trick.

Another good idea. I’ll see if I can insert that into his considerations, however, the coincidence between overwearing them and inflammation is very great and may not be a problem of the eye solution.

Good luck to him. Hope you find the answer and get things sorted out soon.
Do keep us posted.
Rosemary
Thanks Rosemary. Looks like it was early morning when you typed. Get some sleep. Thanks again. Troy

[rosemary johnson]

Hmmm, four years on, it ought to have settled down by now.
It does sound ike a lens tolerance problem. I' not sur ewhy they should be trying to press the transplanted piece down, but maybe if that's what it doesn't like, soemthing like a scleral which asrches clear over the whole transplant and the seam, and can absorb changes of shape of the transplanted area in the tear-reservoir behind its back surface, but be an option to investigate.
Good luck with it all.
Rosemary