Cornea Transplant #2

3/20/08
Second cornea transplant. Everything was just about the same as the first time around...except this time Jason went into the OR with her. She went in at about 11:00 and came out around 1:30. Dr. Zaidman came back into the recovery area to talk to us and he said the surgery went well. He first had to do an exam on the right eye to see how that eye was doing, and then did the surgery in the left eye. Because of some additional scar tissue, the surgery was slightly more complicated than the previous one, but she got through it was doing well. He had to repair the area where some scar tissue was in addition to the cornea, so she has a few extra stitches this time, which is causing some increased swelling and irritation. He explained to me that the extra stitches are actually on the surface of her eye, making it feel bumpy to her. So each time she blinks it's causing some irritation. That area should heal quickly and will look just fine. The pressure in her eyes was still elevated, so she is now going to be using two new pressure drops instead of the one she was previously using. We're not sure why the first one was not working, but hopefully these new drops will do the trick. Some of the increased pressure is due to the use of the steroid drops, but she will need to be on those for a year so these other drops will be necessary to counteract it.

After some confusion about the hospitals age policy for extended observation in the post-op recovery room, we established that she didn't need to stay for the full 6 hours this time. We left after only 4, which still felt like it was 12, but we were just thankful to be able to leave while it was still daylight out.

We had to be back at 8:15 on Friday for him to take the patch off. We had the same anxiety that we did the first time, wondering what her eye looked like. Just after we took the patch off, she opened her eye for the first time and had an irreplaceable expression on her face. It was like she said to her self "wow, that seems different, I can see better now". It was amazing to see her react like that. Although it was swollen, he was able to get a peek at her eye and said it looked good. Then he went down the list of eye drops that she is on and explained what to do with the Left eye.

Her eye drop schedule:

Vigamox (Antibiotic) - 4 times a day in each eye
Pred Forte (Steroid use to prevent rejection of the donor cornea) - Reduce to 6 times a day in the right eye and gradually build to 8 times a day in the Left. By this Friday she will be at 8 per day.
Cosopt (To reduce eye pressure) - 1 time in each eye before bed
Xalatan (To reduce eye pressure) - 1 time before bed in Right eye only. This will change to both eyes in about 3-4 weeks.
Cyclopentol (Dilation drops) - Twice a week in Right eye only.

That's 24 or 25 eye drops per day. It is very stressful to say the least. But we will do what ever it takes so that in the end she will have the best possible vision.

She had a pretty rough weekend, crying the entire time she was awake. Jason and I got only a few hours of sleep that Friday and Saturday night. We believe it was a combination of a few things that made her so upset, but she got back to her regular happy self pretty quickly. Since the surgery she has been opening her left eye much more and we had already noticed some improvement in her focusing on some objects. She was scheduled to have the stitches taken out on April 14th and then she would go see Dr. Morgan, her pediatric ophthalmologist on the 17th. One thing we still needed to look into was finding a pediatric glaucoma specialist that is in our area (and insurance). Because her eye pressure may become a long term issue, Dr. Zaidman said it might be something we'll have to look into.

Emily also had her first meeting with a visual therapist from the early intervention program. We were very pleased with her ability to track shiny items, and of course anything that had a light in it. She used a fiber optic color changing light and was able to get Emily to track it on all directions, even from a distance of 5 feet, for over 20 minutes! She will be coming every 2 weeks to work with her and give us some additional ideas on how to work with her on our own. I will also soon be meeting with the therapist from the commission for the blind. They have their own early intervention program for visually disabled children, so we will get some extra help from them as well. From what I understand, they'll be able to provide us with some toys and objects that we'll be able to use here at home. And if and when she needs glasses, they should also be able to help us with that too.

Emily had just turned 5 months old. Time has gone by too fast. She had already started on solid foods, first eating oatmeal cereal and then moved onto rice. She seems to be taking to them well and soon we'd be adding fruits and veggies! She loved lying on the floor and would frequently squeal with excitement when she was extra happy. She loved to sit and watch baby einstein video's...which are great for her since they are chock full of visual stimulation. She started doing this super cute nose scrunch thing recently, like she's reacting to something that doesn't smell good, it's the cutest thing! So far we hadn't noticed that her vision problems have caused any kind of developmental delay in other areas, which is a good sign...