Muro 128 - Drops vs. Ointment?

[batwell]

I am using Muro 128 5% drops a couple of times a day for ABMD/RCEs but I noticed that in a couple of places the ointment was recommended as the preferred treatment. However, Rebecca's comments on ointments and some past unpleasent experiences have left me sceptical.

So, some questions:

1. Does Muro ointment use petroletum as a base?
2. Does it have the same hypertonicity as the drops?
3. Would it be a good replacement for the Genteal Gel I am currently using?
4. Is light a particle or a wave?

(OK, ignore that last one.)

Any advice, recommendations, opinions, comments, criticisms or general enlightenment would be greatly welcomed.

Thanks

[liz56]

Hi, Batwell.

I am a person who had trouble with Muro 128 5% ointment, and, so I was taken off of it (but left on the drops) after two weeks of use. Others, I know, have had great success with it.

1. Yes. Muro ointment does have a petroleum base.
2. It is supposed to have the same hypertonicity.
3. I don't know the answer to this one. If you want to try it and your doctor says that it is okay, you should. It did not work for me, and my doctor recommended ceasing the ointment and going to Genteal Gel. It seems to be different for each person. If you feel like GG is not working like it could, then Muro is something else to try.
4. :-)

It may be worthwhile looking over Dr. Holly's posts about osmotic pressure as the thing to seek in a solution that helps to heal RCE's rather than hyper- or hypotonicity.

--Liz

[Lucy]

In addition to what Liz said:

Long ago, I was advised to get Muro and got the drops by mistake. They were very painful as I remember. My doctor has told me to use Muro ointment for my RCE's and that I can "use it forever."

(I don't necessarily want to use it forever, still use Dwelle and GenTeal Gel) but just wanted to report on my use of Muro. I always have a tube of it and when things get bad, know I can get some relief from it. (May be short term or whatever, but it is of some comfort.) I resent the fact that I should have to use anything "forever." This event started with my lasik surgery 9 years ago. Lucy

[batwell]

Thanks, I think I will stay with my current program which seems to be working. Artificial tears (Systane) as needed during the day. Muro-128 drops twice a day (morning and before bed) and Genteal Gel with Tranquileyes for overnight. (I just got the Tranquileyes yesterday and I think they are going to work well for me.) I am still forcing myself to wake up at 1:00AM to re-goop but I'll drop that when I feel more confident that things are really healing.

I did read Dr. Holly's posts very carefully and was particularly taken with the following:

"If the semipermeable properties are still present Muro 128 or any hypertonic salt solution will draw water out. Not only that but it will do it more rapidly as the osmotic pressure is hundred times higher than the oncotic pressure. For this reason the better healed the epithelium is the more effective Muro will become."

Since things seem to be healing and my Doctor concurred, I'll stick with the Muro/Genteal.

Thanks.

[Rojzen]

reasoning strong, but

Your application of Dr. Holly's information to the effect that Muro works better as the epithelium improves is logical and sound, but I wonder if you have considered the possibility that high-oncotic pressure drops may out-perform Muro on epithelium in a variety of states.

I cannot currently recall, to a certainty, whether Dr. Holly's work indicates that high oncotic pressure drops do, indeed, outperform Muro on either or both healthy and weak epithelium, but it might be very helpful to explore this in Dr. Holly's writings, to make sure one is not missing out on a solution that could be even more expeditious than Muro, for RCE.

I have never tried Dwelle as a stand-alone product for RCE, since my erosions stopped before I was introduced to Dwelle, but I am hopeful that there are doctors out there who are studying the question of hypertonicity v. oncotic pressure in connection with the rapid and lasting resolution of erosions.

[kitty]

I find the Muro ointment to be the most soothing of all ointments. It is the only ointment I can tolerate. I just don't like the greasy mess I wake up to when using it. It lasts all night where the Genteal gel does not. I think much has to do with the composition of your tear film and what portions of the tear film components you are lacking.

[Rebecca Petris]

However, Rebecca's comments on ointments and some past unpleasent experiences have left me sceptical.

Just to clarify where I'm coming from on this... My skepticism about ointments is in relation to using ointment as a lubricating product, e.g. Refresh PM, Genteal PM and all the other "PMs" out there that are varying combinations of petrolatum and mineral oil. My concern is twofold - how ointment acts on the surface of the cornea, plus the possibility which some doctors have raised of it contributing to blocked glands. In my opinion, ointments are often prescribed for night use simply because doctors are not aware of how effective alternative strategies can be such as the moisture goggles so many people here use, and Genteal Gel and Dwelle.

BUT, ointment used as a vehicle is kind of a different equation. Muro 128 is an example of that; another is antibiotic ointments used on MGD/bleph. Is it ideal, no, but I'd liken it to allergy drops preserved with BAK (which I hate): it's a perfectly fair tradeoff if you need the treatment and don't have an effective, readily available alternative. I think there's a compelling argument that Dwelle is a good alternative to Muro (and it's cheaper and less slimy to use) but I'd never try and urge someone to change if their doctor has recommended Muro and they're having good results with it.

[batwell]

Thanks

Thank you all for your kind words. My second round of RCEs started when we accidentally got the wrong Genteal (PM instead of Gel) and now I guess I have a true phobia about ointments. Anyway, my current routine seems to be working and I really don't want to do anything that might jeopardize that.

However, I will faithfully keep reading this icredible forum for all its wealth of information. I know that it takes up to 6 months to heal and its only been 3 weeks so far. If anything changes I'll reevalute the options. Hopefully in a coule of months I'll be able to post my success story.

Once again, Thanks.

Bob

[lindalou]

I'm pretty new here myself and am trying to educate myself on all of the options/dangers as well. My 3 yr. old's dr. told her to use both the Muro ointment and the drops...ointment at night, drops during the day. I bought the Dwelle, but haven't tried it yet. I would like to bring it to our next appt. and talk to him about it, but there is no appointment coming up!

[liz56]

Hi, Lindalou.

How long has your daughter been on the Muro 128 5% drops / ointment program? I'd give some time, since it is what the doctor suggested. If it works, that's great, and Dwelle can make a nice (comfortable!) maintenance drop once the eye heals.

I hope that things are improving.

--Liz

[Guest]

I recently have been told to use sodium chloride because if I do not my vision will become blurred. I have been using the drops, even though they burn like crazy. Now I accidentally ordered the ointment. What's the difference? Do others like the ointment vs the drops, or drops vs ointment. It's not real cheap so just wondering if I should return or keep.