13 months after operation and 1 after the stitches were removed

It's now a little over a month since the stitches were removed from my eye. I cannot see much better then before they were removed. The topography actually looks worse. I'm a bit annoyed I seem to keep getting my expectations up only to have them dashed again. The promise that I would get the same vision with glasses after the operation as I did before (in three months) seems very far from being met. I was surprised when I received it - so much so that I rang the Doctor and made another trip to Sydney however on being told it emphatically three times I believed it and based my decision to have the operation on it.

I am going back to see the surgeon in early feb. From the last visit it seemed like there was two things he might recommend to me.

Firstly collagen cross linking. He suggested this as a possible way to correct my vision. However after reading everything I can find on the internet about this process it seems to me very unlikely that it will significantly correct my vision. The procedure has a good record for preventing further deterioration - if he tries to recommend the treatment to me for this reason I will have to thing about it seriously. However if he continues to promote it as a means to improve my vision as he did the last time that I saw him, I will need to be convinced that there actually is any evidence of the operation being sucessful in producing significant correction and that this would be likely to appy to me.

The other thing Dr maloof suggested was a drug. I've forgot the name, I am bad with names but it started with R had a "e" and probably a "t" and a "s" I'm sure I would recognise the name. It's fairly new, expensive and not readily available in Australia but supposedly it's much more affective at eliminating allergy symptoms then anything else that does not have serious side affects. Anyway apparently *now* I am told the inflammation from allergies could cause the eye to heal with less then perfect vision.

I don't know what good addressing the allergy problem after 13 months of healing will do for the eye. I will have to ask if the would be likely to improve at this late stage. In any event I would definitely be interested in trying a drug with little side affects that can eliminate the side affects of allergies on the eye. In one of my first posts back in november 2008 I noted that often my right eye has the mostly soreness. This continues to be true and sometime I worry that its vission will be badly effected. Also since writing then I have become fairly convinced that this issue is to do with allergy probably to pollen.

I have reached this due to the following facts.

1. While my eye always seems to have some of these symptoms it seems like in 2008 the symptoms were increasing in oct and nov just before my operation, in fact thinking this was part of a long term trend they encouraged me to go ahead with the operation. In 2009 the symptoms followed a similar pattern.

2. It is possible that the symptoms are just sever case of "dry eyes" which could be expected to be worse in the hotter summer weather - however much use of lubricating ointment and drops provide only limited relief of my symptoms. Also my eyes get better and worse quiet dramatically from one day or week to another which to my limited knowledge "dry eye" would not adequately explain. However it seems that pollen counts in the air can vary greatly from day to day. Also looking at a website that predicts pollen counts it seems like my symptoms often are worst when high pollen counts are predicted. I only discovered this web site recently so I will have to continue to evaluate how hight this correlation is.

Canberra it seems has particularly high levels of pollen. I don't have significant other allergic symptoms which is why partly why I have not looked into this further before. I did see an allergy specialist who from a prick test conformed I am allergic to some types of grass - he also didn't think I probably had a major allergy problem. Since then my symptoms have worsened and apart from the eyes I will don't have a problem with allergies.

In retrospect I wonder if most of my problems haven't been due to allergies - possibly if they could have been dealt with I would not have needed the surgery at all. Possibly if the allergy had been treated with operation would have gone better. Who knows it still may not be allergy - patanal eye drops seem to only improve my eyes to a limited extent and zytec another eye drop for allergies does even less. It would seem my eyes are still able to confuse but it seems like a good thing to try a stronger allergy drug. Possibly a holiday to somewhere with less pollen in the air would also be good and may provide interesting information. It seems my eyes are slow to reveal their secrets.

I started this blog hoping it would make the choice to have surgery easier for others with keratoconus, to let other people know what to expect and even to show that the partial thickness or stromal transplant was a good way to go. Obviously I am somewhat disappointed and my results have not been as promised. At times I've been tempted not to write about my sub optimal results but I figure that if people only write about their positive experiences this would only give a false impression. (Plus it seems good to keep a record of my symptoms, decisions and thoughts who knows what may have some medical value at a latter stage.

I may well be a very atypical case. In theory the stromal transplant seems to make a lot of sense and if you really need to have the operation I would recommend you look into this and hope you find it easier then my to get statistics on the operation. However - I can also advise caution, sometimes things don't work out as well as might be expected! Make sure you really really need the operation before you get it, you may find that you don't see so well after it as you did before. I guess at some stage I may be able to wear contacts again - if so apart from time, pain and money I shouldn't have lost much! :) Actually my cornea is closer to the correct shape now then prior to surgery so just possibly fitting a contact will be easier - I've heard that post transplant a cornea may be easier to fit - but I have also heard they often are not.

I'll probably write again early feburary