Corneal neovascularization & debridement

[miki-mama]

Hello. Thank you all for the invaluable information you share on this forum. I have benefitted so much from reading your posts. I am a SJS patient currently experiencing corneal neovascularization on my right eye. It is covering approximately top 30% of the affected cornea at the moment.

I was wondering if anyone has experienced similar issue, and how you managed it, what kind of treatments you received for it, any success or non-success. Any information you can share, including names of the doctor who are known to be experienced in treating the condition, would be greatly appreciated.

Just to give you a bit of back ground regarding my current issue, I have had severe dry eyes condition, recurring corneal errosion which was resolved after mucus membrane graft to the underside of my eyelids, aberrant eye lashes. I wear the scleral lenses and use the blood serum drops and Refresh Plus, and from time to time Flouromethelone steroid drops. I have gone and seen Dr. Tseng about my current problem, and he has recommended corneal debridement with an amniotic membrane patch. My local opthalmologist is hesitant to agree to the procedure. He is worried that my cornea may not heal, possibility of infection, etc. But he is not offering anything else in terms of an alternative to prevent the vascularization from completely covering my pupil. If I do nothing, vascularization will continue and I will lose sight in this eye. If I do something, I may suffer from other possible issues my local DR is concerned about (infection, non-healing corneal epithilium, etc.) I am inclined to go for the debridement. Any advise or insight would be most appreciated.

MC

[LUCYBELLE2014]

That sound painful. Until now, I thought I was the only one who had this problem. This site and another one has given me food for thought and questions to ask the eye doc! My cornea keeps getting scratched too because of dry eye. They give me contact lenses to wear but I do not think they are the ones you are talking about.

[jadavispcfl]

Amt

Hello,

I'm not familiar with cornea debridement, but I did have amniotic membrane transplantation (AMT) on both eyes in 2010. I had conjunctival chalasis in both eyes, a loosening on the conjunctiva that is a co-morbid disease of dry eyes. I also had MGD with around 3 functioning glands on both lids. My doctor performed probing to open the glands, followed by resurfacing the eyes with AMT. The probing was done first, followed by surgery one eye at a time. I was a total mess before the treatments. I had NO PROBLEMS with the surgery. I wrote about my experience on this site. I hope this helps relieve your fear of the AMT. I still have the MGD, and have had the probing redone, but the surgery was a great success.

[Rebecca Petris]

Miki-mama these are some truly unique issues you're facing. I'm really sorry. I wish I knew more about neovascularization.

Debridement is pretty common for RCE (not always necessary, not always successful). But I have no idea of the implications for your special issues. Question though, what size are your sclerals and how well are they performing for you?

[miki-mama]

I am currently wearing the mini sclerals. Not sure of exact dimensions. They eliminate the pain from the lids/eyelashes scratching at the cornea, and provides moisture so that I can keep my eyes open and be functional. To answer your question more plainly, the sclerals for me are essential. As soon as they come out, I have to keep my eyes closed until I go to sleep.

[xpro]

I'm not a doctor, but as far I know, most neovascularization is caused by lack of oxygen to the cornea. I think there is a possibility that sclerals are cause of the neovascularization. Have you tried probing to see if you can do without the scleral lenses?

[xpro]

I forgot to mention, or you can get lenses that pass more oxygen to the eyes.

[hirentherock]

i agree to xpro that sclerals cause vascularity.I wear sclerals and my eye are also a bit wary to vascularization.
But i have limited my usage of sclerals by wearing it not more than 8/10hours a day with a break of 2hours in between.
U have info on dkt of ur scleral?Higher dkt lense would help u.My lense is 100dkt.As far as i know, upto 140dkt lenses r available.

I dont have much idea of debriment surgery, sorry for that.