Human vision, visual correction, and visual science

Has anyone in this newsgroup had a cornea transplant at Bascom Palmer
Eye Institute in FL?

I have Keratoconus in both eyes. My first cornea transplant was at
Kaiser, in April 2004 by David Gritz, MD, an Oakland CA based surgeon
on their medical staff. The recovery is about a year from the time of
the procedure (outpatient – performed at Kaiser’s Richmond facility)
until the last stitch comes out.

I could see 20/20 out of the surgical eye until the last stitch came
out. After that my vision seemed as bad as it was before the procedure.
Dr. Gritz performed an AK on the transplanted cornea which helped me
regain vision to about 20/40 with glasses … which I am told is still
a good result. The astigmatism left in the transplanted eye is in an
area of the eye which causes contact lenses (even GBL lenses) to pop
out. Now, about 2 1/2 years later, I find my surgical eye is fatigued
by 5pm and the Keratoconus (in my case pellucid marginal degeneration –
a variant of Keratoconus) has progressed to the point that my piggy
back contact lens can no longer be tolerated. Thus I can not see in the
evenings so it is time to make the next big decision.

Last week I had a consultation with Edwardo Alfonso, MD at the
University of Miami Bascom Palmer Eye Institute. He comes highly
recommended by both my optometrist, Dr. Heidi Wagner at Nova University
and my cousin who just had the new, minimally invasive, cornea surgery
called DSAEK (performed by Dr. Alfonso). Dr. Alfonso indicated that he
may (or usually does?) leave stitches in the eye (forever) if 20/20
vision is achieved. Has anyone had a transplant where the stitches
remain in the eye beyond the usual one year recovery period? The
implication is that if Dr. Gritz had left the stiches in when I could
see 20/20 I may have had a more favorable result from the first
transplant.

I now live in FL most of the year so I had to decide whether to have
the procedure in CA or FL. Dr. Alfonso explained that 75% of the result
is a function of the artistry involved in the after-care (stitch
removal) and that he would not recommend having a transplant with one
doctor and the after-care with another.

Stitch removal is scheduled at regular intervals but if a stitch comes
loose or breaks you have to run to the doctor’s office right away.
This happened about ten times during the year the followed my first
surgery.

The problem with going to a nationally recognized teaching hospital is
(in my case) an hour or more drive each way plus a waiting period which
often is 3 or more hours for each visit. This is not a big deal if your
procedure involves only a few visits but If you have to have many
visits for after-care you can plan on losing about a day every time you
need a stitch removed. Bascom Palmer has another location in
Plantation, FL which is close to the area where I live but their cornea
transplant surgeon, Kendell Donaldson, MD is pregnant and will be
unavailable for several months later this year.

I placed a call today to schedule the surgical procedure with Dr.
Alfonso. If anyone in this newsgroup has had a transplant with Dr.
Alfonso please post a reply.

What causes this?  Is it the pupil opening up wider than the optical
zone of the lens (if I’m using that term correctly)?  Does a larger
lens imply a larger OZ?  I ask because I got some bigger lenses to
address some annoying edge effects – and I thought that night vision
might improve too – but in fact it seems to be noticeably worse.  I get
quite distracting starbursts around lights, and if something is backlit
and dim (like at dusk) the light bleeds into the dark and makes it hard
to see.

Assuming this isn’t edema (it doesn’t match the descriptions I’ve read,
which were more like colored halos) are there any parameters that can
be adjusted to try to address this?  Is this likely to be less of a
problem with soft contacts?

–

   I appeared for a vision test in Department of Licenesing (DOL),
Washignton. I have a low vision in one of my eye so DOL asked me to
provide a vision certificate from an ophthalmologist. I stay in
Bellevue, WA. Can someone please tell me where I can get the addresses
of ophthalmologists who can provide me the vision certificate?

I had cataract surgery in my right eye 1 week ago and now the right side of
my head sometimes feel heavy. According to my surgeon, the surgery went well
and everything’s looking good. Since my IOP is normal (16), he thinks that
the slight heaviness comes from my brain still not being accustomed to my
clear vision. Granted, I had cataract in that eye for more than 10 years and
I know it takes time to fully recover. I just want to know if my symptom is
unusual.

Im wearing Acuvue Advanced in my left eye and Acuvue Advanced with
Asthigmatism in my right eye.  I have found that many, I would say
maybe 10 of 24, have ripped where I would say only a couple of my AA
for A have ripped.  I went to the eye doctor today and I told her the
problem and she gave me Acuvue Oasys for my left eye and told me to
keep wearing the same lenses for my right eye.  I asked her how much
asthigmatism I had in my right eye and she said the least amount that
AA for A would correct.  She also said that she has not heard any
complaints about AA in terms of ripping.  Is giving me AO actually
going to do anything about this.  Also do you think that I could
possibly wear AO in my right eye as having AO in my left eye really
wont help that much since when my eyes get dried and tired or whatever
it basically happens in both eyes at the same time.  In addition to
this is there anything that Acuvue might do for me in regards to all
the ripping like send me a free box as I dont feel Im very hard on my
lenses and the AA for A lenses are perfectly fine probably cause they
are thicker or something along those lines.

Any place online that is reputable and cheap for eyeglasses? Thanks.

Is there any medication out there to get rid of floaters in my right
eye? These damn dots keep following me like a fly. Thanks.

What is this that i’ve been hearing about where there are contact
lenses that shape the cornea when you wear it overnight? Is this for
real?

I had cataract surgery in my right eye this morning and the result seems
good so far. The only concern is that I see some halo-like reflections on
the left side of a light source. Is this a common symptom after the surgery?
Thanks.