Wednesday, 28 October 2009

Hard graft

I've just returned from what just might be my last eye operation at the Royal Eye Hospital in Manchester. Why the last? Because if this one does as it should, reasonable vision should return to my troublesome eye within the next few days or weeks.

The run-up: I wrote about what was to be done in my previous post. Mr Au, the specialist, had already determined that I should need a full-thickness (or penetrating) keratopathy (graft). Mr Au was fully prepared to video my operation - at my request - but in the event was unable to do so because the video cables in the brand-new hospital were not compatible with his laptop. For the curious, I've added a YouTube video below of the entire procedure showing how the damaged cornea is cut out and the donor one is placed in the hole and sutured. There's no blood and I find the whole proceedings fascinating and incredible.

What happened? Val and I drove to Manchester on Sunday where I was admitted to be ready for action on Monday. Mr Au bounded into the ward on Monday morning and directed me to an examination room with the usual slit lamp and tonometer (for examining and measuring pressure in the eye respectively). He remarked that the old cornea had deteriorated noticeably since he'd last examined me and gave me a run-down on what he would be doing, knowing that I was very interested in the procedure. Then there was the interminable period of waiting, made more endurable because not only was Val there, but Suzanne and her new baby boy, my grandson, Aaron, were there too. The wonderful new hospitals have plenty of space for walking about, sitting, eating and drinking. Aaron sat on my knee and smiled and gurgled for quite a while.

I was last on the list for the afternoon and was not allowed anything to eat or drink after my breakfast at 6am. Finally, I was gowned-up and checked several times to make sure there were no mistakes
and walked the long walk down the long, brightly lit corridors to the operating theatres and anesthaesia room. It helps to have been through this before but it's always scary. A while later, I came round in recovery and was soon back in the ward. A remarkable thing about modern anesthaesia is that within minutes of coming round, you're ready to walk about and have a good meal. It used to be that you felt horribly nauseous. Not now. So I had my tea and Suzanne helped me out of the gown and into my normal shirt again. They all had to leave by early evening since Suzanne had to get a train back to Sheffield and Val, after seeing them onto the train, had to get a tram and bus back to nephew Dale's house where she was staying. (Thank you, Dale and Debs!)

And the results? I'm sure everyone reading this will want to see what my eye looks like now(!). So here it is:
Not a brilliant self-portrait but you can see the clear central cornea from the donor and just make out the tiny sutures - there are 16 of them - anchoring the graft in place. The white patch on the right was placed there 18 months ago by Miss Fenerty as part of the glaucoma tube operation she performed. This is also from a donor. So my right eye now contains two pieces of other people's eyes. Thank goodness for donors! What a noble thing to do when your life is cut short: bequeath useful parts of your body so that others might see (and many other things) again. Both Val and I are registered donors.

Mr Au examined me yesterday (Tuesday) morning after I'd had a surprisingly good night's sleep with little pain, and pronounced me fit for discharge. The graft was looking good and the pressure was normal. The operation had gone smoothly, he said, and although my vision was - and still is - quite poor, this is perfectly normal. But it is better than it was before and should slowly improve over the next few days and weeks.

And so I was discharged but, owing to some sort of procedural cock-up, Val and I weren't able to actually leave until nearly 5pm because my prescribed eye drops hadn't been sent down by the hospital central pharmacy. A small matter but irritating at the time. It meant Val had to drive back in the dark, through heavy rush-hour traffic and jams because of an accident on the motorway and, later, heavy rain after we entered Wales. She managed supremely well but was quite exhausted when we got back.

I have to sleep with an eye shield covering the eye for a month and not do any heavy work which could damage the slowly-developing seal between the new cornea and surrounding old corneal periphery. The sutures may need to remain in place for 1-2 years and there is a slight possibility that the donor cornea will be rejected by my immune system. I have to be very careful to avoid infection because, when you think about it, there's quite a large cut surface which bacteria would just love to invade. Accordingly, I'm using antibiotic and anti-inflammatory eye drops 4 times a day for the time being. As I write, the eye is a little sore and scratchy when I blink but this should quickly pass. I go back for a checkup in a week when I will find out how things are going. So back to long train journeys again... but at least I can see.

So hoorah for the eye hospital staff and hoorah for the good old NHS!

1 comment:

Anuradha said...

great to hear all about it - though i skipped the pix, despite reassurances there was no blood! sorry val had such a hard drive back. we have been thinking of you and hoping all would go well. love from anuradha and peter xxxx
ps adam may contact you soon about tiki - but he is doing all the work for it, just needs you to think and tell him your thoughts, not write!