Just had prokera done

[MGD1701]

Hi DryEyeNJ
Just find out more/exact status of your glands and causes then decide if LipiFlow would help you.
Sometimes seems probing first make sense. I asked one dr if probing, BlephEx, etc would help me. Yes, he said.
But the dr who perofrms them said I do NOT need them - probably all glands are open?

All doctors just tell me warm compress but HOW to achieve results is not easy and they dont tell me too - dont think they even know.
If your glands are very clogged and oil are thick, dont think warm compress would help but lipiFlow as its heat can reach to inner lids.
To make oil running is most important otherwise glands are likely gone.

[DryEyeNJ]

Hi DryEyeNJ
LipiFlow did help me open all glands - my oil was very thick. Now my oil is half thick, thanks to facial steamer/about 44C.
Some people do not find them useful maybe wrong order or they have more issues to deal with.

I visited 12 doctors and only 2 have good knowledge on MGD but still I need to keep learning, exploring new things and finding solutions by myself
as doctors are not so sulution-driven nor give me treatment plans. I would say I have solved about 75% problems.
We need to be proactive otherwise more glands will be gone.

I saw the price of Lipiflow has gone down so it is becoming intriguing. What doesn't make sense is why would an insurance cover $2,500 for multiple amniotic membrane treatments and not cover Lipiflow? I can guarantee I'll rack up well over the cost of one Lipiflow treatment in 6 months of office visits. Even at $1,000, Lipiflow is an expensive gamble.

Right now I'm sticking to the basics, compresses, lid hygiene, and Omega 3's. You are right about doing your own homework. It doesn't seem that too many OD's or MD's are that knowledgeable on the subject and we need to be our own advocates when it comes to finding relief.

[MGD1701]

Hi DryEyeNJ
LipiFlow did help me open all glands - my oil was very thick. Now my oil is half thick, thanks to facial steamer/about 44C.
Some people do not find them useful maybe wrong order or they have more issues to deal with etc.

The dr did LipiFlow did not tell me (clear/correct) home regimens. If I followed, my glands for sure would be blocked again.
I visited 12 doctors and only 2 have knowledge on MGD but still I need to keep learning, exploring new things and finding solutions by myself
as doctors are not so sulution-driven. I would say I have solved about 75% problems.
We need to be proactive otherwise will more glands will be gone.

[DryEyeNJ]

Prokera and other amniotic membrane transplants are primarily for treating corneal damage, I wore contacts for years and my eyes certainly dried out faster by the time I had lasik. I have read that prolonged contact use affects the nerve endings in the corneas. It took about 2 weeks for me to notice any improvements in the right eye, the left eye was more immediate. If something else is causing the dryness like mgd or an autoimmune issue Prokera isn't going to fix it.

I figured an amniotic membrane would help me since my dry eye symptoms went haywire after lasik. I felt great for about a week, then it came back. I can tell first thing when I wake up in the morning whether it's going to be a good/bad eye day. I like to think that time is on my side, but I am almost three years out (though studies say it can take five years for the nerves to regenerate).

I'm not sure where to go next. I have a bottle of Avenova on the way so hopefully I will experience some relief, even if it's minor. I'm not going to throw large sums of money at Lipiflow and IPL since the vast majority of people here have had negligible results.

At this point, I feel like I'm running out of money, time, and patience treating this disease.

[Clair28]

I had the prokera done. Had the Prokera Slim in for a week. From May 30-June 6. So its been out about a week now. I dont think it did anything :/. But i guess I should see if my eye changes in a few weeks

[Phillips55]

Prokera and other amniotic membrane transplants are primarily for treating corneal damage, I wore contacts for years and my eyes certainly dried out faster by the time I had lasik. I have read that prolonged contact use affects the nerve endings in the corneas. It took about 2 weeks for me to notice any improvements in the right eye, the left eye was more immediate. If something else is causing the dryness like mgd or an autoimmune issue Prokera isn't going to fix it.

[MGD1701]

Hi linguininess
LipiFlow is for MGD/glands issue, like IPL.
I think to identify root causes for inflammation and solve it are important
otherwise your MGD will only get worse.

Lid scrub (x2/day) is very vital for inflammation - to remove bacteria/demodex etc.
Maybe try Avenova, BlephEx and reduce Omeg 6, processed food would help?

LipiFlow and Blephasteam/42.5C have been proved to be effective/safe, especially if glands are clogged or the oil are thick.
Some people find probing first (to deal with scar tissues) is more effective.

[linguininess]

hey MGD1701, that's great you are free of inflammation I haven't tried lipiflow. In the past, I've used hot compresses which seems to introduce more inflammation in my eyes (maybe due to allergies?). Would you know if someone with allergies would benefit from lipiflow?

[MGD1701]

Hi linguininess
We are the best doctors for ourselves, after all we know our conditions better.
I just solved morning/mid-night sharp/sudden pain (over-use of ointments recommended by doctors).
All 3 doctors confirmed my eyes are free from inflammation - which I suffered for some years.

LipiFlow helped opened up ALL the pores - my oil now is still 50% thick.
(all 3 doctors just told me Blephasteam/42.5C, 10 min but I hardly had oil feeling)
I tried facial steamer which helped my thick oil flow.

Perhaps the following could help
*Avenova (wipes) - can remove bacterias, use wake-up and before bedtime, avoid soaps.
(I use soap-free tea tree oil schampoo)

*Blinking exercise

*Goji berry (12pcs) + chrysanthemum with 2-300 cc hot water, per day
Goji has special substance called trimethylglycine. It also comes with polymeric carbohydrates,
which are anti-inflammatory, apart from its rich iron, Vit. A, C (more than beef, carrot and orange).
Better use bio quality as most goji are from China. --- 'prevenion is better than cure' my motto --

[PhoenixEyes]

I wasn't presented with the option of prokera clear. I know there was a prokera verion my dr mentioned but did not recommend: it is the prokera that ships as dehydrated, then re-hydrates it before inserting in the eye. No idea if this is prokera clear, but my dr did not recommend the dehydrated version. It didn't work for me, but could work for you depending on your condition.

No idea either about dehydrated version, from this article on the manufacturer's website it sounds like all Prokera shouldn't be dehydrated as it would destroy the beneficial aspects of the membrane so you're right not to go for that.

There is a quote on the forum from Prokera's founder Dr. Tseng about how the complexity of dry eye conditions will vary its use, and so I think you're right to pursue the underlying allergies angle. The anti-histamine ZADITOR sounds like a good start, hope you find relief. Is there anywhere you can go to for allergy testing? Have you already started wearing protective moisture chamber glasses?

Shea2017: I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor,

As far as Prokera experience goes, it really does vary from person to person I think. I had the Prokera Plus which is double the thickness of the Slim and the same hard ring. My doctor was surprised I was able to tolerate it. I kept the eye closed except to put in antibiotics. I did notice a lot of mucous after a few days but was told this was the first layer of the membrane dissolving / breaking down which looks like mucous. I also did get eyelid swelling the first few days but for me, due to sensitive skin, that seemed to be from the surgical tape adhesive used to keep the eye closed. I fashioned my own eye bandage to keep it closed and the swelling went down.

At the time I was experiencing agonizing pins and needles stabbing pain every day in one eye and I think the Prokera helped as a bandage contact lens with added healing benefits. It hasn't cured me unfortunately, my case is complex, but maybe bought me some time until I can try something else like autologous serum. If you don't mind contact lenses you could also try a scleral lens as a longer term bandage lens with added hydration.

[linguininess]

Was the Prokera Clear not an option? It is the same membrane thickness as the Slim but with a different construction at the pupil to let you see through the membrane easier but it's new to the market I think. Sorry to hear the Prokera didn't work out for you, I hope your doctor can find another route of treatment.

I wasn't presented with the option of prokera clear. I know there was a prokera verion my dr mentioned but did not recommend: it is the prokera that ships as dehydrated, then re-hydrates it before inserting in the eye. No idea if this is prokera clear, but my dr did not recommend the dehydrated version. It didn't work for me, but could work for you depending on your condition. You will see a significant change if, lets say, you had chemical burns. But for someone like me who has red corners in the eyes and normal to mild dry eyes, I didn't notice much of a difference.

I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor, I also have an appointment scheduled with Dr. ****** as a back up should things not work out. I have been through several eye doctors and even relocated from a dry climate to a humid one in hopes it would give me some reprieve; it didn't. I would really like to know your thoughts on Dr. ******. I have been through all the treatments (2 years now) and have never been given a definitive reason for my dry eyes. The most recent explanation I have received is that my actual tears are inflamed which is causing the inflammation of the lids and ocular surface. In the interim, they continue to autoimmune test me. I feel like the doctors are at a loss for a cause and how to treat the symptoms.

Again, it depends on your condition. I believe the cause of my dry eye is from allergies. Allergies to dust, mold, and whatever ingredient it was that my contact lens was made with. My eyes are hypersensitive to bacteria and general environmental dust and particles that my being in a humid or dry environment had no affect on me. I've seen dr ****** and I will say that he is very quick to give a diagnosis and even quicker to perform treatments and surgeries. For me specifically, he did not help me. I'm not saying that he isn't a good doctor, but because my cause of dry eye is fundamentally engrained in my body. My body has allergic (non severe reactions, just annoying reactions) to pretty much everything I come into contact with. If you have an extra $10,000 laying around, then go see Dr ******. If you've been doing treatments for over 2 years now, chances are that Dr ****** will not be your saving grace.

Hi linguininess
Sorry to hear about it. Am I right that if you have both water and oil problems?
You have ocular allergies or inflammation?
If you could be a bit specific, maybe others can share their experience so you can gain more relief!
My experience tells me doctors are not so helpful - often we need to find solutions by ourselves.

100% ocular allergies, which then caused inflammation, which then caused dryness. My osmarity results came back normal. I do have MGD from allergies and using a computer for literally 12 hours a day, which lowers my oils. My main problem is my eyes are over-reacting to possibly everything and I'm just super duper sensitive. I have another dr who prescribed me preservative-free zatidor and I'm hoping I will get some relief from that. Doctors arent so helpful at times because there are 100s of factors that go into dry eyes and it's close to impossible for doctors to consider every single factor. They can narrow it down, but I doubt doctors will find the single root cause of my dry eye. We can only try treatment after treatment until one works. Unfortunately a "cure" for this condition is simply trial by error.

[MGD1701]

Hi linguininess
Sorry to hear about it. Am I right that if you have both water and oil problems?
You have ocular allergies or inflammation?
If you could be a bit specific, maybe others can share their experience so you can gain more relief!
My experience tells me doctors are not so helpful - often we need to find solutions by ourselves.

[Shea2017]

I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor, I also have an appointment scheduled with Dr. ****** as a back up should things not work out. I have been through several eye doctors and even relocated from a dry climate to a humid one in hopes it would give me some reprieve; it didn't. I would really like to know your thoughts on Dr. ******. I have been through all the treatments (2 years now) and have never been given a definitive reason for my dry eyes. The most recent explanation I have received is that my actual tears are inflamed which is causing the inflammation of the lids and ocular surface. In the interim, they continue to autoimmune test me. I feel like the doctors are at a loss for a cause and how to treat the symptoms.

[PhoenixEyes]

my Dr here in LA inserted the prokera slim [...] I could only see cloudy shapes through the prokera, and it caused me to be cross-eyed for the duration of the prokera in my eye.

Was the Prokera Clear not an option? It is the same membrane thickness as the Slim but with a different construction at the pupil to let you see through the membrane easier but it's new to the market I think. Sorry to hear the Prokera didn't work out for you, I hope your doctor can find another route of treatment.

[linguininess]

0% improvement unfortunately