Binocular diplopia after transplants

[MelKap]

Hello,
I am so happy to have found this site.  I received two cornea transplants due to severe keratoconus. The left transplant was done March 29th 2006 and the right was done May 8th 2007.  Since the eyes have healed, I am now experiencing binocular biplopia.  It is very frustrating to say the least.  I have a very high astigmatism in both eye, and have recently undergone incision laser surgery to correct this.  My right eye still needs PRK and we are waiting to see the outcome of the left incision surgery (which was done a week ago) to see if PRK is needed on this eye as well.  I have double vision with the eyes on their own as well, but I know that this is due to the high astigmatism.  My doctor is confused about the binocular diplopia and suggested that perhaps the problem is muscle related.  I am 28 years old and never experienced double vision before (except in the later stages of keratoconus) plus I had muscles testing done in 2005 before the first transplant and everything came back normal.  I petrified that no one will be able to figure out why this happening and I will be left this way.  It is impossible to work, or drive, or function, really.  I am not wearing any correction at the moment because the right can't be corrected without the PRK (the surface of the cornea is irregular) and the left cornea is still swollen from the incision surgery done last week.  Could the fact that I am unable to be sufficiently corrected also be a contributing factor?  My doctors are trying to keep me out of hard lenses (which perhaps could help) because I had my transplants so young and they want to preserve the integrity of the corneas for as long as possible, so I am sort of stuck.  Please, any advice you could give me will be greatly appreciated.  I am at my wits end.  Thank you so much.
Melanie

[John C Hagan III, MD, FACS, FAAO]

I think you have two problems one in cornea and because you say your MD is confused about the diplopia you need to see a strabismus specialist for a second opinion.

JLCH III MD

[MelKap]

The problem is not unusual or it is unusual?  I'm a bit confused by your answer.  So you think the problem is muscle related or cornea related?  I didn't quite get what you were trying to tell me.
Thanks

[John C Hagan III, MD, FACS, FAAO]

Melanie your problem is not usual and can usually be helped. You need the services of a good cornea specialist (you probably already have one) and a strabismus specialist. Between the two types of Eye MDs I believe you will be able to be helped a great deal.

JCH III MD