diving and corneal transplant

[ritas]

Does anyone in the diving community have experience with diving after corneal transplants? if so, I'd appreciate any information that is available about risks, prohibitions or problems with diving after the surgery is completely healed. ( Note this is NOT Lasik or PRK.)

Thank you all you dive buddies!
Rita

[dcsdiving]

Hi,

I had a full thickness cornea transplant in February of this year. I haven't been diving yet, so i can't comment on how that will go. I'll be happy to let you know when i hit the water in august.

I do know of one other instructor who had a graft transplant, and you can get ahold of him through the national keratoconus foundation here: http://www.nkcf.org

So far, things are going well, and i haven't had any complications.

I'll be happy to answer any questions you have about my experience.

geoff

[sbloomer]

Hi,

I had a full thickness cornea transplant in February of this year. I haven't been diving yet, so i can't comment on how that will go. I'll be happy to let you know when i hit the water in august.

I do know of one other instructor who had a graft transplant, and you can get ahold of him through the national keratoconus foundation here: http://www.nkcf.org

So far, things are going well, and i haven't had any complications.

I'll be happy to answer any questions you have about my experience.

geoff

Goeff

I am starting to examine options for correcting my Keratoconus, and would be interested to hear your opinions. At this stage all we have done is looked at eye-glasses and contact lenses, neither of which have been particularly successful. So I am meeting an eye-surgeon next week, to examine corneal transplants or INTACS.

My main question was how long your convalescence was. A previous post suggested a minimum of six months.

Has anyone else got any other advice, tips, what to ask the eye surgeon?

[dcsdiving]

Well, i waited 6 months before diving again, and i had no problems once i got back in the water. i've been taking it slow, and managing descent and ascent very carefully to avoid any hint of squeeze (which is the primary risk at this point, according to frank butler). haven't been deep yet, and may not for a while. i want to be very sure that things within recreational depths are OK.

my transplant was not in response to keratoconus. it was the result of a bad lasik outcome. i have had extraordinary success with the transplant, and am correctable to 20/20 in that eye.

i can tell you that for me, it was a good choice to go with the transplant. in the US we don't have access to some technologies like intacs, so i can't comment on that. prior to the transplant, i was unable to read a book with my right eye, and shapes/figures/life was blurry and not correctable at all. my options were hard contact lenses, which i did not tolerate, or the transplant, or wait (and have it get worse). for my situation, i was not willing to wait for things to get worse (and my vision to become completely useless). i am pleased with the outcome i have.

good luck with your situation. please don't hesitate to ask any other questions you might have.

geoff

[sbloomer]

Well, i waited 6 months before diving again, and i had no problems once i got back in the water. i've been taking it slow, and managing descent and ascent very carefully to avoid any hint of squeeze (which is the primary risk at this point, according to frank butler). haven't been deep yet, and may not for a while. i want to be very sure that things within recreational depths are OK.

Goeff

Thanks for the input, whetever decision we go with I'm going to have to wait until after January to have it done as I am going on a diving holiday in Jan....

I never dive beyond rec depths (now anyway - I used to in the past).

[sbloomer]

Goeff

I went to see the eye surgeon yesterday and it looks like my only option is going to be corneal transplants. Do you feel you have fully recovered from yours? They said to me that full recovery takes about 12 months.

Did you have any vague hints of rejection?

Thanks
Simon

[lostinspace]

my transplant was not in response to keratoconus. it was the result of a bad lasik outcome. i have had extraordinary success with the transplant, and am correctable to 20/20 in that eye. geoff

geoff - would you be willing to share your experience with lasik?

[dcsdiving]

Goeff

I went to see the eye surgeon yesterday and it looks like my only option is going to be corneal transplants. Do you feel you have fully recovered from yours? They said to me that full recovery takes about 12 months.

Did you have any vague hints of rejection?

Thanks
Simon

whoops. i just saw the question. sorry it took me so long to reply. i was also out of the country for a while (in Iraq with the US military), and just got back a few weeeks ago.

i just had the stitches removed from my transplant eye. prior to that, i was correctable to 20/20 in the eye, and able to dive and teach diving with no problem. since removal, the cornea has begun to reshape (which was expected), and until it stabilizes i won't know the final outcome. i have had no problems since the stitches came out, and have been able to dive wth no problem.

it's been 14 months since my transplant, and things have gone well. i have no complaints. one complication is that i now have a cataract in that eye, and this was probably caused by long term use of steroids in the eye to prevent rejection of the graft. at some point i expect to correct this with surgery as well.

all of this is subsequent to a bad lasik outcome, and for me, i can not recommend that procedure for divers. neither does my lasik surgeon any more.

geoff

[dcsdiving]

geoff - would you be willing to share your experience with lasik?

sorry about taking so long. see above message for why.

i'm happy to tell you about my lasik experience. it was not good. prior to surgery i had about a 9 diopter correction in both eyes. this put me in the correctable range, but near the upper end of the range. i did expect that i might need an enhancement, or that my final vision would not be 20/20. i did not expect complete failure in one eye.

had surgery in mar 02, and initial results were not so good. vision only partially improved, although it was mostly correctable. i had double vision in my right eye. then, an enhancement in my right eye in mid 02 to correct double vision. eventually, the flap wrinkled (resulting in blurry vision), and i had a flap lift in Sep 02 to correct that. shortly after that, my vision began to really deteriorate in the right eye, and eventually the cornea began to bulge in an irregular and non correctable manner. that is, i had vision so blurry that i couldn't read a book, and the vision was not correctable in that eye. This lead to the cornea transplant in feb 04.

during this process, i waited the time my surgeon told me to wait before diving (2 weeks is what he said), and then began to dive in a conservative fashion. eventually i began to teach again, and to teach technical diving again. it was after a series of deeper dives that i noticed my vision changing in the right eye ON THE DIVE. i told my lasik surgeon about that, and we worked out a schedule where i would dive at a site near his office, and then have him look at the eye after the dive. he noticed wrinkling in the cornea after the dive that was not present before the dive. the wrinkle would mostly resolve itself after a few days. he did not notice any gas bubbles in the flap, and unfortunately did not take any photos of the eye. the time between dives and exam was less than an hour.

i've written to a navy ophthalmologist (sp?) who is a diving medical officer, and he says the population of technical divers who have lasik is so small that there is no way to predict what will happen. there's no statistical base in other words. apparently divers in general don't have significant problems post lasik, but there's no data about instructors either, that i'm aware of.

so although my experience was sub-optimal (ha!), i had a couple of things that set me apart from the general diving population (instructor and technical diver) and these factors may have contributed to the outcome due to frequency and nature of my dives. there's no way to tell. alternately, maybe my eyes are just way more sensitive to surgery that the average.

i can dive and see pretty well now, but it's taken a few years to get to this point, and i'm not done yet. see above for the cataract discussion.

hope this gives you hte information you wanted. as a disclaimer, i'm not a medical professional, and this is only my experience of what happened to me. it's not a recommendation or advice to anyone.

geoff

[sbloomer]

whoops. i just saw the question. sorry it took me so long to reply. i was also out of the country for a while (in Iraq with the US military), and just got back a few weeeks ago.
geoff

Goeff

Rather you than me in Iraq!!!

Anyway, thanks very much for your input. Just to let you know I had my transplant done last Tuesday (19/04). We in South Africa have a much smaller donor base so the wait was pretty long. The surgery went well, but I had a small cyst develop inside my upper eyelid which caused me significant grief, but this has eased, so other than an eye which feels like a contact lens has been left in it for too long, I'm pretty happy. I had 20/80 and -4.75 astigmatism (uncorrected, but almost uncorrectable due to the keratoconus). After my first visit post-op it went down to 20/30 and -0.75 uncorrected. Obviously things will fluctuate a lot as the cornea settles down, but the doc is thrilled with the results thus far. Were angling to start looking at some correction in about 6 weeks.

Just a bummer that I can't dive for 18 months - I'm scheduled to have the other eye done as soon as the doc is happy with this one.