6/24/09 - Rough Day

So I had a rough day yesterday.

I went back to see Dr. Watanabe after about 3 weeks of wearing my new right contact lens. Unfortunately, I have neovascularization above my pupil. Essentially, this means that blood vessels are growing from my upper eye towards my pupil and are already starting to encroach upon the corneal graft. Apparently, this can be caused by a number of factors, but in my case is either caused by (1) a lack of oxygen passing through the soft lens to my cornea, which may be exacerbated by the fact that the upper part of my eye is also underneath my eyelid or (2) Rubbing of the lens on that portion of my eye, again, this could be also made worse by the rubbing of my lid on the lens. Unfortunately, this may mean that I could be contact lens intolerant, or at least intolerant to the soft lenses. Again, unfortunately, Dr. Watanabe had already tried to fit me with a number of RGP lenses, none of which were a good fit due to the shape/configuration of my eye with the transplant. So, where do we go from here?

Unfortunately, I have the feeling that this is going to be another long journey of trying to find a contact lens that fits my eye. The first step was that Dr. Watanabe gave me another soft contact lens to wear that is apparently more oxygen permeable. He took photos of my eye and of the blood vessels and the hope would be that if this lens let's more oxygen in (and this is the issue) that the blood vessels will not progress in the week that I am wearing this lens. If the blood vessels continue to progress, we have to seek some other options. One option would be to try a sceral lens, which is essentially a very large lens that sits on the white portion of the eye and vaults over the cornea. Again, unfortunately, I had tried this before with the old KC cornea and I had been very intolerant to this type of lens - my eye got all red and pussy and it was intolerable. Dr. Watanabe told me that if we went down this route that we could try a lot of different fits and that it might have been that the fit of that particular lens was not right. This is a big game of trial and error and I know the drill after years of trying different lenses.

If for some reason, this does not work, there are additional options. The first would be to wait and let my eye heal more as the shape/configuration of my eye will likely change as the eye heals. In addition, if Dr. Rapoza can take out the sutures in the eye (he usually waits until the break to do this) it will likely create a different fit for a lens and may create a situation where a lens is easier to fit. Lastly, Dr. Watanabe described two additional procedures that could be options. The first would be doing some type of laser correction surgery on the eye (similar to what lots of folks do to correct vision). He was not very enthusiastic about this approach, as it is very dangerous apparently with a transplanted eye and seemed like a last resort option. Second, was a new procedure that actually inserted a lens underneath the cornea in what sounds like some sort of permanent implant. He did not know if Dr. Rapoza performed this surgery, but said that he knew of a couple of Dr.'s that actually did the surgery - again, this sounds like something that we would only try as a last resort.

So, all of this was not very good news. I guess that I knew that this was a risk of having the surgery, but to be honest it is amazingly disappointing, especially after the surgery going so well and recovering and then being fitted with a lens that let me see things that I have not seen in 10+ years. I was really bummed out yesterday, but my resolve is starting to build again today as I know it is another eye challenge that I will just have to conquer. Again, wish me luck with the next stage of this process, I have an appointment with Dr. Watanabe again next week, so here's hoping that something works!


  1. Good Luck Brent, Hope everything wud turn well. I had my PKP on Rt Eye a month back,. Its quite blurry at this moment, but I am hopeful., specially having read your previous posts...

    Have you tried teh Scleral Lens ?? www.bostonsight.org. These are Magic Lenses. You can postpone teh surgery, for many years, or will nopt need teh KP at all.. tHEY HAVE TEH BEST OXYGEN PERMEABILITY, 5 TIMES, COMPARING RGPS.

    They do not touch your corne, abut rest on teh sclera.. so, very comfortable to wear.

    I wear them in my left.. PLs check with teh doctor. Boston Foundation for Sight manufacturers these lenses.

    Good Luck- Feel free to contact for any further info

  2. Brent,
    Have you tried SynergEyes? I had good luck with these before my transplant until my KC got really terrible. They are a step between soft and hard contacts. It only took me a week to get used to. MUCH more comfortable than RGP!


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