Day 3 with patch My Corneal Transplant

Pre-Surgery Through Day 25

At the time of publication of this webpage 12-10-00, I had been in contact with more than a dozen people in the Fuchs' Friends group who had corneal transplants. Our experiences differed in some aspects, such as type of medications, activity restrictions, follow-up visits, number and type of stitches used, length of time to wear eyepatch, etc. This is the story of my corneal transplant and is not meant to indicate that other methods or procedures are not equally effective.


Nine days before the surgery, I had the required complete physical exam, blood workup, and EKG. Despite just getting over a cold, I came through with flying colors.

Seven days before surgery, I met with my eye doctor and surgeon Dr. Herman Rundle. I had a list of questions for him:

Can I have a local instead of a general? Yes. Doctor said they could administer a general to me at anytime during the surgery if I wanted it.

Will you talk to me during the surgery? (It would make me feel better) He didn't promise anything.

I have developed an allergy to codeine. Is there other pain medication I can use? He said Tylenol would be sufficient. There won't be pain.

When is the latest time I can eat? 8 hours before surgery. However, do take my blood pressure medicine with a sip of water.

What type of stitches will you use? 8 anchor stitches and a running stitch.

Length of time before I can bend or reach? He said unless it is extreme bending or reaching, I won't be restricted. But I shouldn't lift more than 10-15 lbs. for awhile.

How much "rest" time? He said after the surgery I'd probably just sit around until I saw him for post-op the following day.

Can I use the computer? Sure. (Whew!)

He gave me a paper and made me read it and sign it. It said:

"This note is to constantly remind me to call Dr. immediately if I experience in my operated eye any of the symptoms mentioned below for longer than 6 hours:

1. Eye pain or discomfort
2. Tearing
3. Blurred vision
4. Redness
5. Photophobia

These are symptoms of a possible graft rejection which could destroy my corneal transplant and my vision if left untreated."

Then he gave me instructions and prescriptions:

1. Shower and wash my face 3 nights straight with Dial soap to forestall any bacteria.

2. Three nights before surgery stop the Muro and instead put in my eye nightly a line of Ilotycin and rub it into my lashes about 10 X. It's an antibiotic.

3. Two days before surgery, use two eyedrops every 4 hours while awake. One is Ocuflox in a bottle, the other is Acular in single-use ampules. Ocuflox is an anti-bacterial and Acular is an anti-inflammatory.

The morning of surgery I got up at 6 am, ate a bagel and an orange, took my medications with 1/2 glass of iced tea, and went back to bed. Consequently, I did not suffer severe hunger pangs the day of surgery. I don't know why doctors don't tell patients that 8 hours is long enough, instead of that flat "nothing after midnight" business. I kept my lips moistened with hand cream to prevent chapping.

The day of surgery (I will call this Day 1), I checked into the hospital at 1 p.m. A nurse gave me two kinds of drops, one an antibiotic and the other something to dilate the pupil to protect the implanted lens. Surgery was scheduled for 2:30, but they didn't get to me until 3:15. They administered some kind of "blocker," and I never knew when they did it (they ran some knock-out med through my IV for a minute, but I didn't even know it). After I "woke up" (never having realized I was asleep) and the blocker was working, I never felt anything from my operated eye and I saw only light. My other eye was wide awake, however, and I pestered the nursed who was cleaning my eyelashes about what solution she was using. Now I forget what it was, but maybe it was saline and beta-something. Then they put a small oxygen mask on me and covered my face with a plastic sheet so I could no longer see from my other eye, and only the operated eye was exposed. All the work being done on my eye showed to me as only light patterns and colors.

There was a complication in my surgery because the pressure in my eye went very high, making it impossible to put on the new cornea in a flat enough position to allow stitching. They tried feeding some medication through my IV, which helped reduce the pressure in the eye, but not enough. Finally the surgeon (lucky for me he was experienced in retinal surgery, too) removed some of the vitreous gel to lessen the pressure, and then the transplant proceeded. I felt no pain during any of this. I could hear what they were saying and could sense when the nurse handed items to the doctor. I heard the doctor ask another nurse to explain to his next patient that her surgery would have to be rescheduled, because mine was going so long.

What this side adventure meant to me was a longer time on the table in a confined position. Instead of the planned 1 1/2 hours, the surgery ran just over 3 1/2 hours. Doctor frequently asked me if I was OK, and I said yes. At one point they asked if I would like to be sleepier, and I said yes. But I still was fairly awake. I didn't want to miss anything.

I was in recovery a little while. When I left, my instructions were not to bend below my waist, not lift more than 10 pounds, and if I had to cough or sneeze, do it through my mouth--don't let any pressure build up in my head. Oh, also, go straight home and rest.

Because of the long surgery, we didn't get home until after 8 pm. I had no pain around the transplant area. I was glad to get home, eat a quick TV dinner, and go to bed. I knew I couldn't sleep on my operated side, so the bed was already set up with pillows to keep me from rolling that way.

The next day (Day 2) I took it easy until the doctor's appointment. He took off the plastic "tea strainer" and the gauze pad. My eyelid was swollen, but once I blinked a little and got it open, the doctor took a look and pronounced the transplant, "Gorgeous!" Then he called in another eye doctor to have a look, and even let hubby peek into my eye. Hubby said he couldn't believe all those teeny weeny stitches. Then the doctor asked me to tell him how many fingers was he holding up. I said two. Right. He backed his chair farther away. Now how many? Three. Right. Then he pushed his chair clear back to the door. Now how many? I said, "Well, it's fuzzy, but it's your thumb." Then he tested me with letters on the chart. He was delighted and said, "You're already seeing 20/200!" I said, "Well, that's better than the 20/300 I had yesterday."

He gave me an eyedrop regime using the antibiotics and anti-inflammatory I already had, and something called Atropine. He mentioned that one or more of them had no preservatives and on some of them Dr specified "no generic substitutes." I could stop using the antibiotic ointment. I had to work out a chart to get the eyedrops on a schedule. He also told me to keep a soft gauze pad on the eye all the time--up to a week--to remind myself to keep my eye closed, and suggested I keep both eyes closed frequently to help the healing process. He said the body would build a new epithelium over my new cornea. He said to take it easy, not to read, but watching TV or working at the computer was OK. He said I could shower and wash my hair, just keep my eye closed. I only had to put the plastic eye protector on at bedtime or naptime.

The next day I rested a lot, but also ventured outside to have hubby take my photo with some flowers from friends. I also went along with him over to my real estate office to say Hi to the folks and get a hug or two. By the end of the day I had a strong feeling of eyelash in my eye in the inner corner. I took some Tylenol and it went away. I had some tearing, too. The appearance of the eye was swollen and puffy, like I'd been crying all night, but it was not bruised.

Saw doctor early next morning (Day 4), and he said my body has grown 25% of the epithelium back over the new cornea. I told him about the tearing and lash in the eye. He said not to worry about the tearing at this point, but the lash in the eye was a little end of a stitch sticking up. He said he had "buried" the stitches so I wouldn't feel them, but this one end was showing. He sterilized some tiny scissors and clipped off the end of stitch. The eyelash feeling went away immediately. He also told me that moving the eye around a lot might tend to make it feel more scratchy, so I decided to spend more time resting with my eyes closed for the next couple of days rather than working at the computer.

We discussed the way my eye pressure went up and caused that long surgery. Apparently that is pretty unusual. Doctor said he was discussing it with some other eye surgeons yesterday, and none of them had ever seen that. His suspicion is that it was the local that caused the pressure to rise. He said sometimes locals do that. It might be wise to get the other eye done under a general.

The following morning, Saturday, I woke up at 5 am with a big "toothache," but it was in my new eye! That scared the bejeebers outta me. I had been sleeping on my back, and maybe my head had rolled toward the operated side. Not sure. I got up for a half hour and fed my really sore (even the eyelid!) eye one of its ACULAR PF drops and later an Ocuflox. I dug out my doctor's direction sheet:

" Dr. immediately if I experience in my operated eye any of the symptoms mentioned below for longer than 6 hours:

1. Eye pain or discomfort
2. Tearing
3. Blurred vision
4. Redness
5. Photophobia"

I then calmed myself down and said, "If it still hurts by 10 am I will call the doctor." Then I fed myself a pain pill, propped up all my pillows so I was sleeping in a sitting up position rather than in a laying down position, and slept soundly until 9 am. When I woke, I had no eye pain whatsoever and felt great. Methinks it had to do with my sleeping position. The rest of that day I felt fantastic.

Sunday Morning I noticed that my eye was a bit tender, but after the drops and a shower, it was again fine. I ventured out with Hubby to the grocery store, and it was quite a challenge to find things and avoid getting blind-sided in the busy aisles. By the time we finished, my eye felt tired and somewhat strained. But a little quiet time and the drops helped. I began to look forward to the drops, which always seemed to soothe the eye, although they often stung that area in the inner corner for a moment. Toward evening I took off the gauze patch for awhile, but mostly kept the eye closed. When I peeked out of it, I saw very bright color but no focus. I had to remind myself that the healing takes a long time, and even though the peskiness of the drop schedule and limitations on my lifting had made it seem longer, my surgery was only five days ago.

A side note: because of all the hand-scrubbing before the eyedrops, my hands had become very chapped, so I used lots of handcream. I figured out how to stifle a sneeze and to take Actifed BEFORE the allergy attacks I have when the sun goes down. I was also glad I had planned for prunes in my diet. No further comment on that.

Saw the doctor again Monday, Day 7. My epithelium has regrown over 45% of the new cornea. Pressure is still under 20. He wants me to keep the eye covered until 100% regrowth of epithelium. Also add artificial tears in between my RX eyedrop schedule. Do not let the eye get dry. I'm getting into the eyedrop routine so much that if I haven't just done a drop, I know it's time for another one. The names of my eyedrops: Ocuflox every 2 hours, Acular every 4 hours, Atropine every 12 hours, and Moisture Eyes by Bausch & Lomb or Tears Naturale by Alcon for anytime in between.

On day 8 I broke out in a slight rash around my eye, an allergic reaction to the bandage/patch. No big surprise. I never could even use eye makeup or non-allergenic eye cream. Off with the patch.

On day 9 the eye doctor pronounced my epithelium 80% healed over. Only a small pie shape was left to go. Pressure was down to 15. Keeping the pressure down is crucial, because high pressure can ruin the transplant, doctor said. He encouraged me to still keep the eye closed and to avoid a lot of eye movement. I asked if I was healing slower than normal, and he said yes, but I was healing well, nonetheless.

Day 10 was Thanksgiving. I felt great, but I was getting weary of holding one eye shut, and the gauze bandage was out. So I rigged up a mini-patch by cutting the bowl off a plastic spoon, smoothing off the rough edge, scrubbing it well, and taping it over my eye. Helped a lot to keep the eye closed without effort, and got me through Thanksgiving dinner. I admit that my depth perception made for an adventure in eating, with all the stemmed glasses and tall candles. We went to friends' house for dinner, and I packed all my eyedrop paraphernalia in a plastic container to take along and managed to stay on my drop schedule. As I was getting ready for bed that night and putting on my "tea strainer," I noticed that looking in the mirror through one of the openings in the shield I could see my face in the mirror! Not sharp enough to put on makeup, but sharp enough to recognize that it was me. Oh, happy day!! Only downside today, the rash from the gauze patch is still red and itchy.

Day 11. Saw eye doctor. I am 90% healed. Continue drops & closing eye when possible. I rested a lot.

Day 12. Went to lunch and visited family member in the hospital. Still doing the plastic spoon thing. Carried my eyedrop kit with me and didn't miss a beat.

Day 13. Eye doctor met me and 2 other patients at his office on SUNDAY! I could read a couple more lines on the chart. Entire cornea is healed except for 5 tiny spots on the lower edge. Continue drops and cover when possible. I actually did some business calls today. Eye was plenty tired by end of day, however. I look forward to drop time.

Day 14. Monday, and my job cried out for attention. I took care of a lot of phone calls, updated necessary things in the files, did some looking up of things in books, a lot of computer work. By the afternoon my eye was sore and scratchy. I had both eyes open a good part of the time. When I put the big plastic guard on for bed, I noticed I could read my over-sized LED digital clock through one of the holes in the eye guard. I had asked Doctor yesterday why I could read better through that pinhole device at his office, and he said it controlled how much light was between you and the object. He had a big long name for it, which I don't remember.

Day 15. Out and about shopping (not driving). As a precaution I wore the plastic spoon/eye cover.

Day 16. Saw the eye doctor. My eye pressure still in the 12-15 range. Cornea is healed except for 3 tiny spots at the bottom. Reduce Ocuflox (antibiotic) eyedrops from every 2 hours to every 4 hours. Cornea is remaining round, and not tending to any oval shape. Doctor said I can resume my normal activities but should try to close and rest both eyes an hour or so a day.

Day 18: Last night I got some extra pain in my eye--a dull ache. I was really scared. This morning it was better, but not much. I called the eye doctor for an unscheduled appointment. Of course, you know how it is, by the time you get to the doctor, it doesn't hurt anymore! I thought I had overdone it yesterday, because I showed 3 houses, wrote an offer on two of them, and never had time to close my eyes and rest, nevermind being hit and miss on my eyedrop schedule. Real Estate is a NOW business.

Got in to see the doctor about 3, and was very happy to hear him say the eye was not in trouble. It was still "quiet." The dull ache was from inflammation, and now that I am healed he will start me on cortizone drops to relieve that. I was also ecstatic that my vision checked in at 20/70 minus 1 in the transplanted eye! On my best days BT (before transplant) it was 20/80. However, he really REALLY wants me to keep that eye closed as much as possible and not moving all over the place, so I'm back with the "plastic spoon" patch I rigged up. My doctor ordered NO GENERIC on this Pred Forte. So now I am up to 4 RX eye drops a day plus liquid tears. Considering that I used to be a girl who couldn't help blinking, now I could put those drops in riding bareback at full speed on a camel! (Just kidding)

Day 19: I overdid it again today, but it was worth it. We saw a holiday concert with a 100-voice male chorus, and then we saw a 37-voice boys' choir. I defy anybody to see a concert like this and not get a tear in the eye here 'n there. Hubby did my eyedrops out in the lobby before we went in. People probably thought we were kinky! By the end of the concert, my Fuchs' eye was totally clouded over from "misty eyes," and my transplanted eye was hollaring for moisture. But a great time was had by all.

Day 21: Finally picked up my prescription for Pred Forte 1% and started it at noon. Doctor told me to shake it WELL (30 shakes) and use 4x a day. It is a milky color, makes my vision a little foggier, and makes my beer taste funny. But nobody said this was going to be easy. LOL! I already have a plastic lense in that eye, so this cortizone can't give me a cataract.

Doctor says I am healed over now and will take me off two of the eyedrops at the end of the week. I feel great and got my holiday decorating all done, altho I must say I abandoned those top-of-the-ladder lights.

Before I had the transplant, I used to blame my horrible depth perception on having one cataract done and not the other. However, since I can now see from my new cornea (albiet it's out of focus), my depth perception has improved.

Day 23: I've been entertaining myself lately (I'm easy to entertain) by looking at the Christmas tree lights with my Fuchs' eye and then with my transplanted eye. The Fuchs' eye shows each light as one bright center and a few dozen needle-like rays radiating out from the center. The transplanted eye shows not one bright light, but two or three or four bright lights. I finally figured out that at this stage of my healing transplant the fuzziness is actually double, triple, or quadruple vision. I'm back to work full-time and really get mad at myself if I forget to carry along my eyedrop stash. Never thought I'd look forward to taking an eyedrop. Oh, I DROVE MYSELF one block today. So what if it was backstreets and driveways? I made it to a store, bought something, and came back home. Yipp-e-e-e-e!!!

Day 24: Woke up with my Fuchy eye somewhat cloudy, so plied it with Muro drops. The transplanted eye was still seeing double and triple vision, and felt quite like it was dilated, too much light, and "I need reversal drops!" Paperwork was quite a job, but I was able to wrap some gifts, clean the bird's cage, make some phone calls.

Day 25: My vision today checked out (uncorrected) at 20/60 minus 2 in the transplanted eye (Was 20/300 before surgery). The epithelium is completely healed and the eye appears to be perfectly round. I discontinue two eyedrops (Atropine and Ocuflox), stay on Acular another 2 days, stay on Pred Forte approx. 25 days, and next visit will be two weeks from now. I told Dr. my eye seemed to be dilated all the time, and he told me that was from the Atropine, and the pupil would get back to normal in about 30 days (long-lasting stuff!)

Day25 outdoor photo shows my "old" Fuchy eye squinting, as usual.
Evening photo with camera flash catches the glint of the stitches.

Best photo I could get of the stitches.

This story now continues, following the journey of my continuing healing and vision improvement.
Here is my Update.

Dr. Herman Rundle
Eye Physician and Surgeon
Santa Ana, CA


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Page updated July 15, 2005, by Dorothy
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