Kertaconus Corneal transplant

I am 54 year old female. I've had kertaconus for 38 years. I also have Glaucoma which I've had  for 19 years. I have developed a scar on my left eye. I can't read the first line on a eye cart with that eye even with my gas permerable lens. I have alot of trouble driving because I can't see street signs until I'm right on top of them. I also have  severe redness, dry eyes and allergies for which I use many eye drops which only provide temporary releif. It is very painful to wear contacts. I'm aware that the gas perm.lens are the mainstay of TX for my disease. My optometrist mentioned a laser might help to reduce the scar or I may need a corneal transplant. He is opposed to  the transplant beacuse of the steriod eye drops that are used postop. could cause the Glaucoma to get worse. My Glaucoma is stable with good eye pressures after using pressure lowering drops. My visual fields are good. Is it possible to have a transplant with Glaucoma if a laser can't resolve the scar and increase my visual acuity? I have scars on my right eye also but I can see pretty well in that eye. Do you have to have poor site in both eyes before a transplant is concindered? I'm I excluded form a transplant all together even if I go blind?  

[Sandy Feldman, MD, MS]

Dear cathy213,

I would recommend that you speak with your eyeMD specializing in cornea. If you are having trouble with contact lenses, a corneal transplant might be an excellent way to improve your sight.  There are other treatments including collagen crosslinking, intacs, many different types of contact lenses and eyedrops to assist in reducing allergic signs and symptoms.  Collagen crosslinking is performed in the U.S. through experimental studies but internationally has been shown to reduce disease progression.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California