Everything with my eyes is great.  I continue annual exams which include a look at the graft and it has been completely quiet.  My allergies kick in occasionally but I manage those with Allegra.

I’ve been doing Tobradex (a combination of tobramycin and dexamethasone) prior to influenza vaccines and COVID shots, but I’ve recently learned that this may not be required?   I’m planning to ask my doctor soon.  If it’s not, I’ll update the posts I have on here about using it.

I spend a lot of time hiking, mountain biking and kayaking with my wife. 

A short post today.  With the sutures coming out slowly over time, it’s always been my choice to put off getting a new eyeglasses prescription.

With lenses being so expensive, and insurance limitations, it hardly made sense to pay for a new left lens every few months as my vision (astigmatism) was altered by the process.  I was already tweaking expensive contacts to follow the “suture roulette”, so I chose to hold off on the glasses.

Well, with all sutures out and a month of stabilization, I’ve finally got new lenses for my Oakley glasses.  It’s amazing to have spectacles that correct nearly as well as my contacts – and liberating.  I can now feel more confident on driving holidays where I might find myself at the wheel longer than my lens wear time allows.  And I can easily drive should a mid-night emergency happen.

With allergies wreaking havoc on both eyes this Fall, I may choose to wear the glasses more often, allowing me to use eye drop antihistamines anytime I need them, avoiding the drowsiness that comes with their oral equivalent.

I cannot remember when I last had glasses that worked so well – but I’d guess it’s been nearly 15 years.

So, yet another little thing that the DALK surgery has brought me, more than two years later.

The broken suture was no fun, and I have to travel some on business – was worried that would happen in an airport or in front of 200 people.

So today, he cut the last four from my graft.  There are now no mechanical connections between my body and the donor’s cornea.  That made me anxious for some reason, but I was reassured that it would be fine (unless I got boxed in the eye!)   We tested my eye pressure, vision and did a topography.  All good.

Time to remove the sutures…

The normal drops for numbing and within 5 minutes he’d removed them.   We talked again about PRK surgery in 5-6 months and I was on my way.

Ow.

After the numbing drops began to wear off, I took a couple of Tylenol.  But it was pretty painful.  The longer sutures are in, the more they seem to hurt after removal and numbing meds wear off.

Ow. Ow. 

By 4-5 pm I was very uncomfortable, and took 1/2 of a stronger pain pill which helped.  Also added some Systane to my eye – because the pain is likely caused by the inner eyelid rubbing on the freshly cut areas of my eye.

My plan is to medicate myself liberally tonight and hope that things are better in the morning.

Our PRK discussion was about trying to get my left eye free from the need for any contacts at all.  I asked about risks and Dr. Holland made the point that the risks for PRK are about the same as long term contact lens use (infections.)  So I am strongly considering it, despite the out-of-pocket costs and another procedure on the eye.  We will discuss in 4 months.

Follow up:  2 days later.

Pain is gone and only a residual dryness remains.  I have been doing my antibiotics.  Went metal detecting Saturday and Mountain Biking Sunday and it was great.  Safety glasses for sure!

Well, it’s been a good week for my DALK recovery.  I went back to Dr. Holland for my graft checkup and he said it was perfect.  I also corrected to 20/20 on their refraction gear.  I had already ordered a new, special soft contact (see last post) and was not able to take it with me to Dr. Holland.  He wasn’t bothered by that and said that if the soft lens worked for me, it would be fine for my eye.

The downside to the soft lens (at least the first one I tried) is it corrected me only slightly better than 20/30.  This means there is room for improvement.  But the comfort is … amazing!   The fitter (Tamra at Dr. Koffler’s office here in Lexington) seems to think that I should wear it for a week and then we may want to correct the power to hit near 20/20.

Other questions answered:

• Sutures:  We’ll take them out if they degrade.  Otherwise, he said, leave them in for now.
• Graft Fragility:  I had lots of anxiety about the graft’s fragility, but Dr. Holland told me to quit worrying.  It would take a severe trauma to disturb the graft now that it’s healed up.
• Rejection Period:  I’m exiting the prime rejection period for DALK.
• Glasses:  Dr. Holland said to go ahead and make the lenses for glasses.
• PRK/Lasik is still an option if we cannot make contacts work.   Insurance won’t pay for that in KY (or OH.)
• If we run into suture issues (e.g. one breaks) we will remove them all at once.
• He said it was right to stop wearing the RGPs if they were hurting.  He said I should be pain free and use whatever gives that to me.

Exciting!

A very big day on this long journey.  Today, I inserted the mini-scleral lenses in my grafted eye at Dr. Koffler’s office…and, for the first time in 15+ years, I had clear vision in my left eye.  My brain and eye muscles are not sure what to do with the new information so the crispness came and went, but here are my unfiltered first impressions:

• Wow.  I can read the doctor’s diploma across the room.
• The world is sparkly!
• Everything’s in 3D!
• Look at the birds!
• Look at the clouds!!!
• I don’t want to take this out!

I was only at a 3-hour wear limit today, so pulled them out mid-morning.  I’m looking forward to inserting them again tomorrow.

The removal was touch and go because I’m out of practice, and the eye is just slighly “dry-sore” tonight.  Nothing bad at all.  Totally expected.

I got a ‘care package’ with new plungers and other solutions, etc from the office.

NEXT UP!!!

• 3-D Movie!
• Stargazing!

Postscript:  Day 2, 3 of lens were tricky.  Eye was a bit sore from lens and insertion / removal was difficult.  I’m clearly out of practice on this.  Still feel a lot of anxiety about damaging my graft with lens effort.

http://corneanews.com/about-kerataconus/chronology/

The tip I have is this… ask the doctor or assistants if you can have a sample antibiotic (left by drug reps) rather than a prescription.  The samples have just the right number of drops for 4×3 or 3×3 and are meant to be given away for free.  This can save you the cost of the antibiotics and a trip to the drug store.   Even ask them to give you several bottles to be used on the subsequent visit (they have a decent shelf life.)

The doctors can get more, trust me.

This might save you $30-40 per visit.