The State of My Right Cornea

The State of My Right Cornea

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My Eye and Some News About It by Jon Armstrong for blurbomat.com. Copyright/credit: Jon Armstrong.

I’m feeling this one. Click image to see larger version. If you dare.

Took this with Hipstamatic and then fed it to Decim8. Appropriately distressed given the news from a couple of weeks ago that my right cornea is the thickness of an 85 year-old person’s cornea. My doctor said that a lot of people would opt for a transplant at this point, but if I could, put it off for as long as possible. He mentioned that he’d do a larger cut on this transplant and that might help him with the corneal curvature issues I’ve faced my whole life. I’m holding off as long as I can.

I’ve known for a couple of years that this donor cornea was on the outs. In late 2010, I noticed, as did others, that my right eye couldn’t find a place to focus, moving all over the place. I mentioned the scary cloudy cornea swimming incident (here) and I keep going back to that outing as the tipping point for the transplant.

I wish it were different, but I’m likely looking at a new cornea in 6 – 18 months. I’m hoping to push it until the ACA kicks in and I can buy competitively priced insurance.

Knowing what the recovery looks like is helpful, but I’m pretty freaked thinking about the failure rate of a cornea transplant (it’s not high, but enough to cause the needle to jump), just as I did in 1998 when I got word a donor cornea was available. In my dream world, it would be ideal if I could grow my own cornea or better, 3D print a perfectly shaped matrix that would serve as a scaffolding for an artificial cornea that would never be rejected or fail. One can dream.

When I brought this up with my doctor, he said while he was leaving, “You are on the right track when you talk about printing a cornea. They’ve tried stem cell experiments, but nobody can get it to work. Hold off on the transplant as long as you can,” implying that new technology was coming. As I write this, I just did a search for “printing a cornea”. I found this:

New Company Applies Regenerative Medicine to Corneal Transplantation

“The new approach, not yet tested in patients, involves isolating cells from “banked” donor corneas to grow replacement corneal tissue in the lab. The advantage is that cells from a single donor could potentially benefit multiple patients with impaired vision.”

and

Mayo Clinic: Cornea Transplantation: The New Era of Endothelial Keratoplasty

“Corneal transplantation has evolved rapidly over the past decade, as surgeons strive to refine selective tissue transplantation to treat diseases that affect specific layers of the cornea.”

Nice. Here’s a video showing the procedure the Mayo Clinic article discusses that will likely freak you out. I was awake (but drugged to the hilt) for my first transplant. I don’t remember a small putty knife being inserted into my cornea, but hey, the internet is awesome:

[youtube http://www.youtube.com/watch?v=8DgWhHOYUHo&w=600&h=450]

Try to watch it all the way. The post operative eye will blow your mind with how quickly it seems to heal, especially after the insane surgery. Every time I see a video like this I can’t stop thinking that somebody figured this out. They figured that you can graft a donor cornea from a deceased person onto a living donor’s eye. Somebody with a lot of spine said, we can fix this and they figured it out.

It’s a crazy thing to be awake and have your cornea sliced. Moral: waiting is a good thing.

  • http://kristanhoffman.com/ Kristan

    “Somebody with a lot of spine said, we can fix this and they figured it out.”

    I love that as mankind’s motto.

  • tchemgrrl

    My Ph.D. thesis was largely concerned with artificial corneas, at least one little piece of the puzzle: getting the epithelium to reform in a nice way to reduce the chance of infections.

    The short answer is that there are artificial corneas out there but they’re not nice yet, unless you have a chemical burn or disease that leads to not having enough good tissue to use a donor.

    But better ones are definitely being worked on. I’m a few years out of date on the literature and I wasn’t on the clinical side of things to begin with, but my group did some lab animal tests that seemed promising.

    (And hi, this post could not have been more specifically tailored to bringing me out of lurkerdom if you’d tried.)

    • http://blurbomat.com/wordpress/ blurb

      I’m sharing my eye-related situation in the hope that I’ll learn something from my smarty-pants readers and that anybody who lands here might learn something. Thanks for sharing!

  • http://twitter.com/Sadandbeautiful Sarah R. Bloom

    Woah.

    That is all.

  • http://twitter.com/uauage Sol Kawage

    wow that’s intense! I didn’t know you had already one “borrowed” cornea. What was that like? and why? sorry just curious.

    I wish you good luck with your eyes, and with everything else.

  • MyPetGloat

    Sorry, I don’t have the courage to watch the video. Eye surgery freaks me out. I wish you all the best with this Jon and thank God for modern medicine!

  • americanrecluse

    I had to scroll very very quickly past the video because just the still frame was too much for me. Aaaiiieeeee!! I hope your new one winds up being one of those 3D printed ones and lasts forever.

  • http://twitter.com/LisaHartford Lisa Hartford

    I’ve had two procedures (ahem, ouch) to treat my corneal dystrophy but can’t fathom how awful a replacement might be. Is this because of Fuchs?

    • http://blurbomat.com/wordpress/ blurb

      Keratoconus. It’s more weird than bad. My vision for the years immediately following the surgery was really good. But the past couple of years, I’ve struggled.

  • http://twitter.com/Baketown Bake Town

    My son has Keratoconus too. He had a transplant when he was just 16. I still worry all the time that he will need another or something will go wrong. Thanks for posting. Good to know.

  • Sarah H

    As a heart transplant recipient who was advised in 1988 to hold onto my own heart for as long as possible, I can vouch for your doctors advice. When I finally did have my transplant in 2006, I had exhausted my native heart, but the advances in technology and meds were completely worth it.

    I am well aware of the fear of the failure rate of transplants and I actually do not even read survival statistics. Too freaky for me. When the day comes that they grow or print – PRINT – organs, you will see me dancing in the streets.

    My only hope is that they could maybe clone my current transplanted heart. This sucker kicks so much ass. I love it with all my…well…you know.