Also known as “Corneal Sutures”, they are sewn in as to ensure that the newly transplanted cornea stays in place and attaches well to the rest of your eye as it is supposed to do.
After the surgeon carefully and skillfully lays the cornea in to position, he/she will thread a specialized sewing needle as to begin the suturing process.
The following is a picture of one of the types of needles that they will use on the cornea. It is called a Kalt Corneal Needle.
They will use the claw-like needle to thread the corneal stitches through to attach the new cornea in place.
There are a couple of different variations as to how the stitchings are done. And every doctor has his or her preference. Plus it also depends on the patient and their needs as well.
One is called “Interrupted”. Which means that instead of a “zig-zag” effect, there is one line stitchings that kind of resemble the lines around the sun from a child’s drawing.
The other suture possibility is called “Continuous”. That type of suturing looks (to me) something like a drawing (yep, I’m stuck on kid pictures lol) that a child made, using the old drawing toy called a Spirograph.
Then there are some cases where the doctor uses BOTH of the techniques. In the same eye. Again, it’s done on a case-by-case basis.
The following is an example drawing of the sutures that I had described above.
Post transplant, over time as healing progresses and all is well, the Corneal Specialist will look over the eye and eventually decide that it’s time to start to remove stitches. But not all are out at once. It’s a gradual and even a bit of a tedious process.
When it’s time, the doctor will ask for his Nurse Assistant to go grab the removal kit. It will have two things in its sterile packaging. A forceps tool and a blade tool.
These are called a “Meyerhoffer Chalazion Curette”. They help (as long as I do indeed have the correct blade) to cut the stitch(es) that the doctor wishes to remove.
The above set of “tweezers” are called “Arruga Curved Capsule Forceps”. And hopefully, I do have the correct pair. Once the appropriate stitch(es) have been sliced loose, then the tweezers are used to (gently) pull the stitch out from the cornea and eye area.
Anyway you slice it (get it?? lol) they must use a blade and tweezers to cut and remove the sutures. They are not dissolve-able. So removal is indeed a must.
There are VERY rare occasions though, that do warrant stitches to stay in place for the patient’s life.
But before that, they will place in some numbing eye drops and use an eye separator. This way, there is no pain and no chance of you closing down the eye as it is being worked on.
The Eyelid Speculum Device is usually metal and looks like the following…
And your eye looks like this after placement….
And no, it does NOT hurt to have it placed under the lids, nor is it painful as it is within the eye area. Cold. That’s about it. But then you have the drops placed in and all is well.
One of my awesome pals from Twitter and Facebook (we initially “found” one another through a friend of a friend on Twitter) has recently had a corneal transplant done, due to having Keratoconus (cone shaping of the cornea). Brooklin (ItsBrooklin on Twitter) is also a professional photographer who does great work with picture-taking.
Earlier in the week, while on a shoot, Brooklin had a buddy take a picture of his eye where all of his stitches were in. For Brooklin’s case, he had BOTH the Continuous, as well as the Interrupted suturing performed on his transplant eye.
First of all, THANK YOU Brooklin for letting me use your eye as a prime example of explanation for this post. You couldn’t have timed posting the picture really any better. And also, dude… You have BEAUTIFUL brown eyes. They are like Amber Brown. My favorite shade of brown.
Well, I hope that this will put your mind at ease, as well as help you to better understand the process of having stitches both placed in, and removed from your eye once you have had a Corneal Transplant. It looks scary to go through. But really, it’s not too bad. Personally to me, the worst part is honestly the speculum.