I knew this day was coming, I felt it in the deepest part of my heart months ago, but that didn't soften the blow at all. Today was just verbal confirmation from the doctor. Emily's cornea had failed...she would need another transplant, the third one in this eye. Her doctor seemed hopeful, almost enthusiastic about her chances of better vision. But the risks for both failure of the graft and complications with her eye pressure and cataract were higher than the previous surgeries she had been through. Still, the risks did not outweigh the benefit. With her cornea badly damaged, beginning to cloud up and scar tissue blocking a portion of her vision, the reality of NOT doing another transplant meant her vision would continue to deteriorate. Surgery was necessary.
Dr. Zaidman ultimately left the time frame of the transplant up to us, we could do it as soon as January, or wait for a better time over the next 6-8 months. I hated the thought of putting her through this surgery again, but putting it off for a more convenient time in our lives seemed pointless. So we scheduled the surgery for January 22, 2015. It was after the holidays and would give her enough time to heal before spring and summer. She would need to be out of school for at least a week and no gym or sports for a month.
The other issue we needed to address was the cataract. Originally Dr. Zaidman wanted to remove it and replace it with a lens implant at the same time as the transplant surgery. But for some reason now he felt that it would be better to do the transplant first, wait for her to heal and then go back in to the the cataract surgery. I was concerned that this would possibly interfere with the health of the new cornea, but at the same time was leery about doing both surgeries at once. The complications that could be triggered were serious...I hated that she had a cataract in the first place.
I believe that all the surgery that her left eye endured was the reason her retina detached...too much for her eye to handle:
- 2 cornea transplants, 2 Ahmed Valve implants, multiple surgeries to remove scar tissue from the valves drainage tube, removal of the cataract, lens implant and Vitrecotomy (removal of the jelly-like substance within the eye)
She has had slightly less complications with her right eye, but more surgery meant more chance of compromising the Trabecalectomy (new drainage path created for eye fluid to drain from), which meant we could be struggling to control her eye pressure again. And if cataract surgery was needed, disrupting the back of her eye could spell disaster and total blindness.
I had to believe that this next transplant would be a new, fresh start for her. It would be the best donor tissue yet. There were no other outcomes I would even let my mind consider. This might be Emily's last chance...