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  • PTK surgery for Recurrent corneal abrasions?

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    Old 12-19-2005, 07:35 PM   #1
    dmbfan
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    PTK surgery for Recurrent corneal abrasions?

    Hello,
    Brief history: I've suffered from abrasions for about 16 years now. I've also had two quite significant injuries (cuts) to my eyes. The abrasions occur weekly, sometimes nightly, sometimes they may stretch out to a month between them. In the last 2 years, I've suffered from 3 major tears when waking up that required immediate medical attention (torn off over 90% of the epithelial tissue) So now I've had three docs suggest PTK surgery. At first I hesitated, but after my last major tear, I'm ready to have something done to help. It is suggested to me because the epithelial tissue is so scarred and rough that abrasions are inevitable...

    So anyway, I just got the packet of info from the doc, and I read through the risks....and of course got scared to death....

    Has anyone had this surgery? Does anyone know anything about it? Success stories and not-so-successful are both appreciated. I think I need some more info before I make my final decision.

    thanks!!

     
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    Old 12-22-2005, 05:35 AM   #2
    ebmd
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    Re: PTK surgery for Recurrent corneal abrasions?

    Quote:
    Originally Posted by dmbfan
    Hello,
    Has anyone had this surgery? Does anyone know anything about it? Success stories and not-so-successful are both appreciated. I think I need some more info before I make my final decision.
    thanks!!
    Hi dmbfan -

    I had PTK for recurrent corneal erosions about 4 years ago. I was having nightly (and often mid-day) erosions that were taking off usually 40-50% of the top layer of the cornea. PTK stopped it immediately, and I have not any since then. For a few months after the surgery, I had a very mild episode maybe once every 3 weeks, but these were most likely not actually erosions. Prior to my surgery, my cornea was also way too scarred for traditional techniques to work (Muro, drops, etc). I had also attempted "anterior stromal puncture" twice, which failed.

    PTK is a much scarier-sounding procedure than it actually is. The procedure lasted like 5 minutes - they manually scrape off the top layer (which is the worst part of the surgery, even though it doesn't hurt), then they blast the cornea with the laser (which you practically won't even be aware of except for the sound of the laser). Recovery varies - they told me I'd be "uncomfortable" for 4-5 days, and that the pain would be like having a bad erosion. I did not find this to be the case. For one, the pain was more of a throbbing pain, and for another, I was probably only uncomfortable for a day or two. To be honest, I didn't even use pain killers - I found a typical erosion to be far worse. Vision is blurry for a few days, but should be clear after 5 days. I had a very experienced surgeon, and maybe that's why my experience was so positive.

    Yes, there are risks, but the scary outcomes are so rare that the risk of *not* doing anything is probably worse. The one downside is that my eyes are more dry now than before, but I would hardly say that I'm annoyed by it.

    Generally, PTK is very successful. The published stats say 90%, and the 10% that don't work are almost always cured on a 2nd try.

    There is a thread here called "recurrent corneal erosion." I and a few others have posted there several times about experiences with it, so search there for more details. People have also talked about their techniques that help prevent erosions without surgery. These techniques work well with mild cases of RCE, but may not if your epithelium is so scarred. The success that I had with PTK is such that, if I ever develop recurring erosions in my other eye, I'd immediately go for PTK rather than be a slave to the erosions.

    Good luck,
    ebmd

     
    Old 12-27-2005, 01:34 PM   #3
    dmbfan
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    Re: PTK surgery for Recurrent corneal abrasions?

    Thank you so much for the input! You really put my mind at ease...

    Were your eyes very dry before the PTK? Do you just need to use artificial tears often now?

     
    Old 12-28-2005, 06:21 AM   #4
    ebmd
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    Re: PTK surgery for Recurrent corneal abrasions?

    Quote:
    Originally Posted by dmbfan
    Were your eyes very dry before the PTK? Do you just need to use artificial tears often now?
    Hi dmbfan -

    My eyes were not too dry before the surgery. But it's not so bad that I have to use drops during the day. I now use Genteal Gel (Severe) at night only. The "severe" variety of Genteal is thicker than a drops, but does not have the pasty, vaseline feel to it that ointments do. It also helped reduce the number of erosions before my surgery, but not completely.

    One other comment about PTK should you decide to get it done - sometimes PTK is done over the whole cornea, sometimes only over the part that they think is scarred. I think when they PTK the entire cornea, it's more successful.

    Hope that helps,
    ebmd

     
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