Corneal keratopathy...

[Rosedal]

Hello, I’ve been diagnosed with a “little” cataract and a corneal keratopathy (a calcification on the cornea!) on my left eye.  The doctor removed the cataract and scraped this keratopathy.  It has been 6 months since then and now my eye is worse than before, my vision is blurred, I can’t read without difficulty, it feels as if something scratches in the eye ALL the time.  Also some pain, and a gentle heart-like or pulse-like beating at times within the eye.  No amount of artificial drops gives any relief.  Only closed eye feels good.  My surgeon told me it’s not going to get any better!

My right eye seems fine though was told I have a cataract just beginning, but I’m now reluctant to have it done for fear of complications...again!  I will appreciate immensely an opinion, i.e., am I right in seeking a 2nd opinion?  Do my above symptoms seem like they could stop???

I’m in the 80s, female, only reading glasses, and in quasi perfect health...I’m now searching for an ophthalmologist to obtain a 2nd opinion.  Meantime, could anyone recommend a competent and conscientious ophthalmologist in NYC?  

Thanks ever so much!    :o)    Rosedal

[Christopher C Shen, MD]

The symptoms of pain and blurriness sound like they may be due to the irregular corneal surface following the scraping procedure rather than the cataract portion.  If your vision in the other eye does not seem to bother you or is correctable to a satisfactory level with glasses, no downside to holding off additional surgery but I would seek a second opinion from a cornea specialist (ophthalmologist fellowship trained in cornea and external diseases) to see if any additional improvement can be done on the original eye.  Lot of good doctors in the academic centers within NYC (Mt Sinai, Columbia, New York Eye and Ear, Cornell).  

[Rosedal]

Thank you so much Dr. Shen!  I'm glad you say there's a possibility to do another surgery to improve my cornea, because I was rather depressed when I had read somewhere in the Internet that a 2nd surgery may make the cornea too thin.  I hope I can find a good surgeon soon.

Thanks a lot again!    Rosedal

P.S.  My surgeon works at New York Eye and Ear Hospital and there it is where I went yo see him and was operated on.  

[Christopher C Shen, MD]

If corneal thickness is an issue, additional surgery may involve doing a complete corneal transplant.

[Rosedal]

Thank you again Dr. Shen, so that I can understand better, does this:

  "If corneal thickness is an issue..."

mean that I may have too thick a cornea?  Or does it mean that because the keratopathy scraping didn't  work, it might be advisable to have a cornea transplant?  Or perhaps you referred to the thickness of the keratopathy cloud?

If a cornea transplant is as easy (apparently to me) as a cataract lens transplant, then I wonder why my surgeon didn't consider it at first since he did say it was a rather large cloud?  Instead he said afterward: "It won't get any better".

It's very sad and frustrating and am hoping to obtain a 2nd opinion soon.  Until then, I really appreciate your feedback very much!  :o)

Rosedal

[Christopher C Shen, MD]

If your cornea is too thin, there is a risk of perforation with additional surgery, therefore the alternative is to replace the cornea with a donor graft.  This is a much more extensive surgery than cataract lens implant since one is replacing live tissue from another person so there is a risk of the tissue being rejected and additional risks of glaucoma and infection.  

[Rosedal]

Ah, I now see this matter much more clearly Dr. Shen!  How does one find a donor?  Alive?  Or from a deceased person?  And is finding the donor up to the patient or the surgeon/hospital?  Or are the corneas preserved?  Of course, knowing how difficult my case may be I'll try to be very cautious...

I shouldn't disturb you anymore now.  Thanks so much for your kindness and helpfulness!   :-)

Rosedala