Last updated: Dec 29, 2005
I spent the first half of the year 2004 trying to get into surgery to do cataract removal and Iris Ring implant surgery (next section of website). The day before my surgery was to occur, the surgeon told me that my cornea was in very bad shape and should be repaired first. The trail led to the exploration of KLAL surgery. This is an attempt to briefly explain what the KLAL surgery is.
The section on Keratitis and Cornea problems already covers most of the condition information. However, there are some points that should be made.
There was a gradual vision loss that happened over the years in my case. The changes aren't noticeable day to day, but when looking at the difference of several years it is. My recent more rapid vision decrease is also more pronounced while looking at closer objects, like TV or computer screens, paperwork, and detailed work.
The damaged cells (scar tissue) produces an irregular shape and/or less transparent areas. One doctor compared looking through my cornea as to looking through a window with sheets of water washing over it. Objects on the other side, which are visible, are distorted. I have previously defined this effect as a loss of detail rather than loss of focus because most of the stuff I see appears clear to me. But my perception of vision has always been based upon what I see and not what good vision would likely provide.
The scar tissue spoke of in the Keratitis document is a direct result of my whole inherited condition maze. In my case, some new cells being produced are defective and end up contributing to the scar tissue problem. New, good cells are needed to clean up the cornea. What I have been avoiding so far is a discussion of these stem cells. This is where I stop avoiding that subject.
Stem cells are cells in the body that don't have a particular designated purpose in life. When they are needed for a certain function, they configure themselves for that purpose. Science has experimented with stem cells for years. A lot of research has revealed that this aspect of medicine can provide many solutions for people otherwise thought to be untreatable. There are some informative links about stem cells in the web links area of my Vision and Health page under the General Health topic.
The problem is that a close cousin of stem cell research is the DNA reproduction experiments that have also been done. Cloning is among that group of study. The media has grouped all forms of these groups together and has many people convinced that all forms of this research are morally wrong.
To me, cloning and attempts to alter human DNA is wrong. The medical aspect of using stem cells to grow or heal a person back to normal health is NOT wrong. I do not believe we should try to build the perfect human, but I do believe in making our current bodies work and feel like it is intended to function normally.
There are many different types of stem cells, grouped by where they come from. Embryo or fetal cells are another source of debate in the media circus and political debates. It is sad that so much is made of a small part of the entire research when many donor organs and stem cell tissue comes from adult people who have passed away. These donors are valuable resources to others who need such organs and tissues. This is an important difference because, in cases such as mine, adult tissue was used and would have otherwise been wasted if that person had not signed up to be a donor.
The problem with stem cell grafting is similar to transplanting any human organs from one person to another. The two people must be a similar match in type in order for the new parts to be accepted by the body. Even very close matches are different enough to produce a possible rejection.
The very same immune system that protects us from assorted disease is the primary blocker in stem cell (or organ) acceptance. The system thinks the new stuff is an intruder and will fight against it. This is called rejection. When stem cells (or organs) are transplanted, patients will have to also take special medications called immunosuppressives which suppress the immune system. Therefore, the person can be more likely to get diseases during the time they are using this medication.
From what I have read, immunosuppressives are applied directly to the region of transplant if allowed. If the transplant is an internal organ, this is not reasonable. In the case of corneal tissue, medicated eye drops can be used to allow application to the region. This would allow more medicine strength to reach the cornea instead of being delivered throughout the body by the blood stream. It also makes sense because the cornea is not supposed to have blood vessels in it which would deliver the medication.
It is said that the chances of new tissue rejection depends greatly on the patients body to tolerate change and the closeness of match in tissue type. If rejection does occur, the process starts over again with finding another tissue donor and another surgery and medication period.
The procedure is called Kerato Limbal ALlograft (KLAL) and is one of many subgroups of cornea therapy treatments. It is considered a therapy because the success is based upon the cornea healing itself rather than an implant device being put in. Even with a full corneal transplant, the eye must accept and merge with the new part. Research is ongoing and even into 2005 the process is considered experimental. However, there is a growing knowledge base of the practice and methods to pull it off successfully.
Basically, KLAL means grafting (Allograft) new cells (Limbal) into the cornea (Kerato). The new cells grow and clean up the scar tissue from dead original cells. New cell tissue is taken from a donor. If a KLAL patient has one good eye, cell tissue from their good cornea can be grafted into the damaged cornea. This will drastically reduce the chances of rejection. If both eyes are affected, cell tissue from a donor person must be used.
In the case of stem cell grafting, the outer circle of original corneal tissue (where the stem cells are) is removed to a certain depth from the patient. The amount removed will depend on the size and shape of the donor tissue. The goal is to use as much of the donor tissue as possible, but not cut away more original tissue than there is replacement for.
For complete corneal transplants, the inner portion or all of the cornea is removed. Again, this depends upon the donor cornea and the needs of the patient.
Once the new tissue is attached in the area left by the original tissue, the surgery is complete and the rest is up to the patients body to do.
Before I got a shot at surgery, I had to go through a series of tests on the eyes and general health. This testing is important to help determine if a patient is capable of going through a surgery without problems and to help identify conditions that either already exist or that may develop during or as a result of the surgery. Testing will vary between patients based upon what surgery is being done and any health concerns involving that patient. The following is just the particular process which I went through before surgery could occur.
Before any of my scheduled surgeries, I had to go through a complete physical examination by my regular family physician. This included the standard office visit testing as well as detailed blood testing. This process is easier if the patient has done regular yearly checkups as the doctor will have a better knowledge of the running health record. Since I had been doing these for the past few years to keep track of a former elevated cholesterol condition, my current results were easily compared to recent examination results. Blood tests are needed to provide additional information about the patients health.
A complete eye examination is also in order within a reasonable period of time prior to a surgery. Past medical records are great, but they can't match current specifications that will be present at the time of surgery. Just like above, this process is easier with regular yearly vision exams being done. Even with low risk surgery, unidentified conditions can result in serious complications. So the goal is to get as much information as possible so that the surgery team is prepared to deal with events that may be likely to occur. If the surgeon is not the patients regular vision care provider, it would make sense that the surgeon will require at least one exam with the patient. It also makes sense to me that the surgeon would be the best person to perform the follow up exams required after surgery. In my case, the surgeon was a fairly new doctor to me, but we did have several exams during the period of other testing being done.
The surgeon also scheduled me for retina and optic nerve testing before surgery was setup. This not only helps to identify problems with the overall vision after surgery, but helps assess the risk of retinal tearing or detachment as a result of eye surgeries. My left eye retina appears to be healthy according to the doctors, but they can't get a view of the right eye retina for inspection. However, the retinal testing will produce a far better analysis than visual inspection and will give a much more accurate determination of health.
I was referred to a retinal specialist who did a retinal scan of both eyes. This testing revealed no apparent problems with either eye. Since my right eye is so blocked, the surface of the retina had to be inspected with an ultrasound test. The vitreous fluid in both eyes also appears normal. This testing turned out to be the most positive point in the year 2004 for me because retinal and optic disc problems are among the list of conditions that go along with many Aniridic patients.
My surgeon also scheduled me for detailed corneal mapping and scanning. This helps them to determine the thickness of the cornea as well as the shape and uniformity of it. Though I try to be a very cooperative patient, my eyes aften have their own agenda and they did not play nicely with the test devices or people. We have this same dispute over the pressure and slit lamp tests and my eyes usually get the last word in. Together, we have tormented quite a few doctors and assistants with repeatedly failed attempts. This testing was no exception.
One more very important thing needs to be done before surgery, getting everybody on the same track. Insurance companies want patients to get preapproval for non emergency surgery, referring doctors need to get medical records forwarded to the doctors they send patients to, and patients need to make sure this is all getting done. I have found that many doctors offices handle this well or give the patient instructions on what they need to do. However, there were a few situations last year that made me realize assumptions aren't always good to rely on. In one case, both myself and my surgeon fully believed that another doctor who was going to handle my prescriptions would do so, but that was proven untrue on the day of my scheduled surgery. There have also been two events where my insurance company had the wrong idea of what was going on. As hard as my new doctors office has worked for me, they are but one piece in the whole puzzle. I learned a valuable lessone this past year. Patients need to check, recheck, and confirm that the process is understood by everybody involved. Let the people who are doing a good job for you do their thing, but don't hesitate to get into the picture when there is an indication that one part isn't working. Work with the doctors office, insurance, and others involved instead of just yelling at them. Mistakes happen, problems can occur, and policies aren't always fair. However, a patient who is well informed of the process they are going through can help things along if they use a civil tone of voice and a reasonable attitude. It ain't a perfect world, the goal should be toward finding a solution to problems rather than adding tension and stress to them.
Sometime before the day of a surgery, the patient also needs to have a plan in place for the event. Outpatient surgery (such as mine was) is easier to deal with than a hospital stay. Even so, many things need to be considered and arranged before the event. Will you need a ride to or from the facility, will you need to stay with somebody overnight or for a period of time, when to stop eating or drinking before surgery, what restrictions will be in place after surgery, etc. Much of this information will probably be provided by the doctor or facility in advance, but the actual arrangements are the responsibility of the patient.
This is an attempt to share the accounts of my KLAL surgery. This is my personal experience only. Different surgeons and patients will possibly have different accounts. This is written to give an idea of what can be expected during the surgery itself. Both of my eyes may eventually get this procedure, but this round dealt with the left eye only.
Pre-op and post-op surgery seems to be pretty standard routine. The patient is prepared as in any other outpatient eye surgery. Anesthetic is administered to the eye region and prevents it from moving or have feelings. Only the eye area itself was affected, I could still talk and had feeling around my face. I was awake during the procedure.
There were three steps to the process. First, the surgeon cuts tissue from the patients eye. It appeared to me that the tissue was taken in one piece rather than in sections. Next, the surgeon cuts the donor tissue to match the shape and size of the removed tissue. This was done at a seperate table away from my location. Lastly, the donor tissue is sutured in place where the removed tissue used to reside. I also received amniotic tissue as a layer of protection over the top of the cornea. This protective tissue will dissolve over a period of time.
Because the patient is awake during the surgery, a communications exists between the surgeon and the patient. The patient can tell the surgeon of any problems they are experiencing or even ask questions (as I did). My surgeon kept me informed of what he was doing, what I could expect, and why things were being done. I also got to listen to the surgeon asking for tools and then watched them being used on my eye. Most of the images were cloudy due to fluids being on the eye surface, but I could still make out the tools and movements. The communications came in handy as there were two times where I felt pain sensation during surgery. The staff dealt with the issue very quickly and the pain was gone.
The procedure takes about two or three hours. Honestly though, it seemed very short to me. I was completely interested in the show before me and trying to understand the surgery details. I had forgotten all of the tool names and the medical terms (except those I already knew) before I could record them, but I will never forget the experience. The surgeon and facility staff made the afternoon a comfortable process and I was not concerned or scared during any portion of the event.
It was a very interesting experience for me for three main reasons. First, I had heard a few stories of people who had undergone eye surgery and got to watch the work being done. I didn't know how I would react to that. It was almost like watching a movie or TV show because you know that things are happening but can't really feel it (excepting some movement sensations). I joked prior to surgery that they better strap me in because of possible reaction, but I had no desire to react even due to natural reflex.
I also gained respect for the surgeon whose statements reflected close attention to detail and care for his patient. I can't remember an example in words, but I recall knowing many times during the process that the surgeon mentioned to his assistant a reasoning for doing something that he did.
The most outstanding part of the whole day, perhaps for the whole year of 2005, was what happened in the middle of surgery. When the surgeon is done cutting original tissue, they lift the tissue and put a cap over the eye while preparing the donor tissue. In the one split second of time between the tissue being removed and the cap being placed, I saw the light fixture directly above me. It was a very bright and clear light fixture, the clearest image I have ever seen. Now I realize that my vision has never been good and that fixture was probably pretty close to me, but that image left an impression. It was a very brief glimpse of hope that someday, somehow, I might have that perception of other objects too. Childish? No, amazing!
Like the surgery section above, this is my personal account of my recovery process. It is divided into two parts because they are different enough to break up. Short term and long term recovery are covered.
Because it is outpatient surgery, the patient is sent home after surgery to recover. Family or friends should transport a patient and it is suggested that the patient not be alone at least the first night. I believe this is a wise suggestion as my relatives provided both physical and emotional support that night.
I left the facility with a dressing and a hard patch over my eye. The dressing protects the eye and absorbs fluid while the patch protects the eye from impacts and reflex touching. I had a follow up exam the following morning where the patch and dressing were removed, but dressings can be continued as needed to help absorb fluid. My doctor was right when he told me the fluids would be worse in the mornings. Therefore, I wore dressings with the night shield for the first week until I noticed the pad was almost dry one day.
A plastic or metal shield is worn for several weeks during periods of rest to continue preventing any accidental eye contact. The patch does not need to be worn during periods of awakeness, but I found it really doesn't hurt to have it on to be a reminder not to touch the eye. Vision wasn't good out of the eye anyway so it wasn't preventing sight.
The first two days, pain and cloudy, watery vision were the order of business. This is completely understandable, but that didn't make the situation any easier to take. It is advised that the patient get as much rest as possible to start the healing process. The regiment of healing and immunosuppressive medications begins the day after surgery.
Since my left eye was in recovery, I had to rely on vision from the right eye. In my case, the right eye has always been the worst of the two. This presented a challenge although I found out the right eye produced good enough sight to function at least enough. I imagine patients with better vision in the other eye will not experience my type of problem here. I got to play target practice with the other eye for about a week and that in itself was a whole world of experience.
My first signs of healing were noticed at about 48 hours after surgery. I was able to stop taking the pain reliever medicine outright. While I still felt some minor pain and discomfort, it wasn't overwhelming enough to swallow yet more pills. Everybody has different pain threshold levels, so others results will vary.
Eye drops are applied four times (or more) daily which produces a roller coaster effect. About an hour after drops are applied (in a sequence), the eye respondes with less pain and some less watering. This lasts maybe a half hour before the trip back to pain and fluid until after the next dose of drops. The last peak (as I call it) in less pain and fluid on my second day after surgery yielded a bit longer comfort time. It was good to know that the eye was responding to the attack of medicine.
My body responded on the third day by taking several short naps. I wish they were longer, but I take what it gives me. Between the naps and the medication sessions, I didn't get to do much study on peak comfort times. It was good though as I had two doctor visits ahead of me the following day.
On that fourth day, I was away from home for about six hours. I was surprised that I made it that long being able to see anything at all by the end. I did have many eye drops with me on the trip, but there is no opportunity for a nap. I survived the very long day and experienced the first real signs of improvement. The doctor slightly decreased the application of one of the eye drops, yet a long way to go is still in my future.
The rest of the first week resulted in a gradual display of healing both through increased peak times and more clarity in the view. Realizing that the only part of my eye which was changed was the outer layer of the outer cornea, I didn't know what differences would be presented in my images. My research has told me that the cornea is pretty important (all parts are), but there is a much deeper understanding of that when the bad tissue is no longer there.
As the second week moved along, the peak times just kept slowly getting longer and longer. The eye still had periods of random watering, but not as severe as in the first week. Not so much detail gain or noted sight improvement happened. Most of the improvement has been due to the protective tissue melting away which takes the semi-transparent tissue out of the view. As the skin (conjunctiva) grows back over the cornea (which it is doing in the second week), the shape of the cornea will be more natural and should again show a slight detail gain. I am not sure what gain will show as the cells clean up the rest of the original cornea during the long term recovery period.
I consider the last day of the second week to be the end of my short term recovery process and the beginning of the long term recovery journey. The reason is that this seems to be the linc between the highly physical portion of the recovery and the remaining internal cleanup that will go on without the discomfort and watering (so far as I know to this point).
As for the long term recovery, my third week was hampered by problems with my sleep cycles and therefore the eye responded with more watering and fatigue than it should have had. One of the many side effects of some medications is sleeping problems and I think this kicked in for me. I had trouble staying asleep for more than two or three hours in a row, when I could fall asleep. I tried to counter this with very frequent nap attempts, but these rarely worked. While the eye kept healing during this period, it showed me that it wasn't too happy with the limited sleep the body was getting.
Just as the third week ended, my body finally took the hint that I was trying to force upon it. I spent the better part of a 32 hour period in broken but restful periods of sleep. One day later, the watering that had been present the last several days had mostly gone away. I had three real good days in a row, but the body started fighting the sleep again and the watering returned the fourth day. I got some sleep that day though and the watering tapered off again.
Ever since the last part of the first week, there has been a sensation of something being in the surface of the eye. This thing seems to be constant in place during the day, but in different places each day. I equate this to being the growth or healing on the surface of the eye. It is a minor discomfort factor that is felt but not enough for me to want to react to it with touch or rub reflex. It is worth mentioning though because it is a very real part of the recovery. I could kind of tell that my healing was continuing just by the movement of the sensation and the fact that it was moving around. This is one of those things that you have to experience in order to understand.
As I reached the end of the one month period, the eye just keeps on healing and feeling better each day. The vision improvement for me has been mostly in the detail and sharpness of the image rather than the size of objects. I realize that the cataract on the lens is a real big part of the reason for not having better vision at this point. Even so, I am very happy with what has been restored so far.
Another effect of the medications is possible weight gain and water retention. I noticed that my appetite had increased and I was getting hungrier sooner. I was told to monitor my blood pressure and weight for increases. The blood pressure has been good and I have only gained five pounds on the scale, but it seems I am eating a lot more than I used to. During the fourth week, I started my exercize routines on a limited basis again. My energy level is increasing daily, so I can do more to keep in shape and hopefully offset some of that weight gain.
The main progress of the fifth week of recovery was the fact that the outer eye is almost completely healed. Just a bit of protective tissue needs to melt away and a bit more smoothing of the cornea will happen. The vision is just slightly improved in clarity over about a week ago, but objects still aren't really bigger. I have noticed that the spot which I see (due to the cataract) while looking through binoculars or magnifiers is much more defined and present in the image.
I have been intentionally using my right eye (worst vision of the two) as much as possible over the last week or so. During the time that I am applying drops to the left eye, I have to use the right eye if I am to see anything. I figure the right eye should not be neglected as it provides the worst image to the brain. I really can't say that the vision has improved, but my perception through it seems to have. I am finding navigation around objects is easier to do. This could have to do with targeting also because now the brain is forced to deal with the offset perception more frequently and might be getting used to it.
Today I tried to read text from a book with my highest power reading glasses. The book of choice has slightly larger than normal book size type. Although I couldn't read it with ease, I could recognize most of the words without much question as to if I was accurate. This same book was unreadable with the reading glasses one year ago. I am back to about half of full magnification while using the CCTV documant text reader, from full power just prior to surgery. So although the vision is still well below legally blind, there is a bunch of improvement to be really happy about so far.
In addition to the eye health and vision examinations, I am also being monitored for the major effects of medications. Monthly blood tests are required for this. So far my blood tests have not shown any problems. However, I am aware of more minor side effects going on. My blood pressure and pulse are up as is my weight. I have gradually increased my physical activity level. This has helped to keep the weight from continuing to climb farther.
Six weeks after surgery, an exam revealed elevated eye pressure in only the left (treated) eye. This sparked the need for another eye drop application to counteract it. One week later another drop was added as not much difference resulted. My examination just shy of two months after surgery showed the pressure was finally back down closer to being normal. Also during this session, loose sutures were removed.
From two months after surgery onward, the recovery consists of routine multiple daily oral medications and eye drop applications. My doctors adjusted medications based upon results of exams and monthly blood tests. The hardest part for me is getting the oral medications down. That has never been an easy task, but I've never taken so many before. Those that are taken with food are easier because you can swallow them with a spoonful of food. The ones taken without food are harder, but I have found ways of getting those down more often than not.
The sleep pattern issus has never really worked out. For the most part I find myself laying down when I feel tired and hope for sleep. It has been rare to get over five or six hours straight sleep though. I don't know how much of this is medication reaction or something else.
Just over four months after surgery, I got clearance to continue with other surgery treatments. My surgeon was very happy with the progress to date and the cornea was being stable. While the medications and recovery continues, it is good to know that things are on track.
About seven months after my KLAL surgery, the same surgeon performed the Cataract removal and lens implant surgery. For the rest of the first year after the initial KLAL surgery, the cornea remained stable. According to my doctor, current studies show that the medication will last about five years to insure the tissue is not rejected. I feel very fortunate that one fifth of that time has passed with no major problems.
With the KLAL surgery, the post-operative medications are an absolute critical point of the process. These medications provide for the healing factors as well as the prevention of tissue rejection. The best plan is to follow the medication orders with no variation.
I will not list my personal medication regiment here as I am not a medically trained person. What applies to each patient is up to their doctor based upon many personal factors such as overall health and level of surgery performed. However, I can't leave this be without at least going over some points which I feel are important.
My medications included four eye drops, one eye ointment, three prescription oral pills and two over the counter oral medicines. Most of the eye drops must occur four times a day evenly spread out. One drop started with applications every two hours and was tapered off somewhat after about a week. Some of these medications will be reduced or eliminated as healing progress continues.
The overall goal is to administor enough medication to provide for a successful healing and immune system acceptance without overly using the medicine which can increase chances of side effects and other problems with the body. Frequent (monthly or more) blood and urine tests assist in monitoring the levels of medications present in the system. Adjustments can be made based upon these reports as well as physical exams and patient feedback. As is said alot through my websites, the patient must communicate openly and honestly with the doctor(s) in order to obtain the best treatment.
Although medical technology has made tremendous advances in the last decade, the art of medication is far from a perfect match with the properly working natural human body. Many of these medications have a list of side effects and potential serious diseases associated with them. The risk should be minimized as the health of the patient and knowledge of doctors increases, but there will always be some risk. For me, the choice to have the surgery done and go through the host of medications was pretty easy. My vision was rapidly getting worse and the risks are less guaranteed then an eventual loss of vision. Each patient will have to make this decision on their own.
The total cost for this (or any other) surgery will be determined by many factors. The best thing to do is to ask questions and gather information during the inital stages of setting up surgery. In my case, insurance decided not to cover the surgery because it is still considered experimental (though it has been performed for a few years in the USA and more years overseas).
Most of the charges were shared with me in advance as approximations. I found there were some other charges that apply just a few days prior to the surgery. Therefore, I will list the type of things I paid for so that others can be more prepared to inquire.
The fees that the surgeon charges will vary with the doctor. I paid just under $10,000 for their portion of surgery, which includes some payments made for pre-surgery exams and testing.
Facility fees include charges paid to the hospital or facility where the surgery occurred at. These include use of the surgery area, the surgery devices, pre or post operative items, etc. There was also a fee for the anesthetic services performed. My facility fees came in at just under $7,000.
There are also charges for the donor tissue and the protective tissue. I did not know the protective tissue applied to my surgery until just prior to the surgery itself as it was listed as done with certain types of procedures. Cost of these tissues was just under $2,000.
Thankfully for me, insurance is covering a portion of the medications that must be taken after surgery. The estimated list of these over a six month period is over $7,500 and many of these will be taken for at least two years up to the entire lifetime. That makes the cost of medications to exceed the cost of the surgery itself in the long range.
Also of note is the cost of the regular lab tests and examinations that will follow up the surgery over the next few months and years. Weekly office visits (for at least a month) and montly lab work are the agenda after surgery. The frequency of visits and process will likely vary between patients based upon health and problems. Still it is another cost which needs to be considered as it will happen.
Is it worth it? It was for me! This was something that had to occur in order for me to go back to the original planned surgery of the Iris implant and cataract removal surgery. The goal of the KLAL surgery for me was to provide a clear view of the inside of the eye for the next surgeon to be able to do his work. Even after a week from the surgery itself, my doctor said he had an excellent view of the lens and cataract. This means that provided no problems occur, I might be able to have the other surgery this year also.
Aside from that, I am also realizing more detail in the image than I had prior to surgery. The vision is far from even good at this point, but it is much better to have it going in the direction of getting better or being stable then getting worse. Time will tell what the future holds, but my improved emotional level alone is worth a lot to me and all things considered I feel this was a good thing to do.
The vision recovery from KLAL is gradual. Once the grafting is done, it takes time for the new cells to clear the cornea. Since the new cells are grafted on the outside edges of the cornea (for stem cells), the vision restoration will likely occur in tiny steps that will not be noticed excepting in long term periods.
The information I have read states that the process of KLAL takes from six months to a year to clear the cornea. Patients have frequent follow up exams and blood tests to insure the immune system is under control, and there are no signs of tissue rejection or side effects from medication. These can continue for two years or longer from the start of KLAL, depending on the patient.
If a cornea is damaged too deeply, the stem cell graft may not be able to solve the entire problem. It is possible that a patient may need a corneal transplant even after a successful stem cell graft. The general feeling seems to be starting with the minimal treatment felt is needed to solve the problem and increase the efforts if demand is present.
Sadly, some insurance companies feel that stem cell replacement is not a useful thing and refuse to cover any costs. Ironically, immunosuppressives seem to be covered as standard medications. Even if the surgery is covered, the patient is commonly charged up front for the cost of the donor tissue and will have to settle with insurance afterward. Donor tissue can cost hundreds of dollars in out of pocket expense to a patient.
An attitude check is a good idea for any surgery or procedure. Patients that expect the best outcome (perfect vision in this case) will likely be disappointed even on a very successful completion. I was looking forward to basically ANY gain in detail or size and have already experienced some of that. So for me any future gains are considered wonderful instead of expecting more first and being disappointed later on. While I do have dreams that someday I might experience even better vision, I also know the difference betweens dreams and realistic expectations. The best plan in my opinion is to accept what you get and enjoy it.
| Next Section | Previous Section | Give Vision resource website | Terrys Place main menu | Vision and Health Page | Terrys Seasonal Place |