Getting puncta sutured shut - anyone else? How did recovery compare to cautery?

[Guest]

So, since my stubborn upper left puncta isn't getting the hint and shutting itself with cautery, next up is the cautery/suture combo. You know, on the one hand, it's kind of cool the way the body can heal itself so darned well... too bad in THIS case I'd rather my body just go with the flow and let my doc cauterize the heck out of that puncta and shut it once and for all. Well, I suppose we can't be 100% sure it's not shut, but based on the evidence, there's a very reasonable likelihood that it's still open.

So, I'm being sent to a plastic surgeon ophthalmologist that my corneal specialist said he'd even trust with his mother - he said this guy will do a better job of it than he can, so better to take the referral for this one. Fair enough - I respect his honesty, and definitely want the guy with the most practice to give this one a go! Crossing my fingers that this does the trick. I was thinking I'd like to try this procedure, and glad he suggested it.

So, anyone who's had this done, was the recovery any more uncomfortable than plain cautery?

With plain cautery, as long as I don't irritate my eyes by looking around lots (ie. just chill out and listen to an audiobook, go to bed early that night etc.) I'm good to go the next day for the most part (if I recall correctly... hmmm... ought to read some of my old posts to confirm... they've become my on-line diary of sorts for how things went )

Now with a stitch being added to the mix, wondering if that will be noticeable in the recovery process?

What say you?

[spmcc]

It's so strange that you would post this now, today, when I just got home from an appointment with my 6th oculoplastic ophthalmologist (over ~3 years).

I went to see this "renown" guy in Vancouver because I'm having such a bad time with my right eye. It stings and burns and I have to give myself a "tape tarsorraphy" every day (I know, how pretty - but at least it's under my gorgeous moisture chambers! harhar!)

Other doctors had mentioned the possibility of a retraction surgery with grafts to "lift" the lower lids and cover more sclera for comfort and I wanted another opinion.

Anyway, The Big Guy (with 2 fellows + 1 student) examined my eyes and we discussed my history (17 years - there's too much). I explained that all of my puncta are sealed - 3 cauterized and 1 sutured (lower right - my worse eye).

The Big Guy says my cauteries are all still closed, but my sutured punctum is open. What?!?! To confirm, he flushed it with saline and it poured down the back of my throat! So, I think it's been open all this time (since early May 2011 when it was done).

Well, what may be interesting for you is that The Big Guy said he'd never heard of suturing puncta shut (and asked the other 3 guys if they had - No). Keep in mind, he also said that he didn't understand why I've had so many cauteries (~9 times since the mid-1990s) because, he said, "Cautery is permanent... well, sometimes they open". In the end, though, he re-cauterized my "sutured" punctum so fingers crossed!

I guess what you want to know is, for me, cautery and suturing recoveries were very similar. For e.g., sometimes I'm a little bruised after cautery (probably from the injection) and that's how I was after suturing. What is also similar is the kind of "full" feeling in the area and, of course, the rebound effect of any dyes and/or anesthetic drops. I felt/feel pretty much normal (our normal) the next day.

The difference between cautery and suturing is the actual procedure - or more specifically, your ability to WATCH the procedure. Personally, I have no problem with doctors doing things to me... I never flinch or make noise or anything. Cautery is quick - you can see the smoke and even smell the burning, but it's quick. No biggee. But I was kind of grossed out AFTER suturing because you can SEE the thread and needle going back and forth sewing your flesh (sorry!). I was fine DURING, but afterwards I got a little freaked out. Just be prepared if that would upset you.

Regarding the stitches... yes, you can see little black stitches and the ends peeking out. They didn't bother me at all... and no one said anything about noticing them.

That's about all I can think of to compare the two. There's really nothing much to either of them... just *try* to make sure that your suturing is permanent. How you do that, I don't know!!

Good luck with everything.

[Guest]

Cool.. thanks for the info, it's much appreciated!

So, question about those stitches being visible... is it very obvious to other people that you have these freaky stitches sticking out? or do you really have to LOOK for them to see them? Do they rub on your eyeball until they dissolve in a way that you can actually FEEL? ARE they dissolving stitches?? Pleeeeease tell me you don't have to go back and get them actually pulled out!!!

Sorry for all the questions, just want to know exactly what to expect... I worry less when I can mentally prepare ahead of time! I'll be fine I know... like you, I don't squirm, make noise or freak out during these things... but I DO tend to have a million questions running through my mind ahead of time, that's for sure!

[spmcc]

So, question about those stitches being visible... is it very obvious to other people that you have these freaky stitches sticking out? or do you really have to LOOK for them to see them? Do they rub on your eyeball until they dissolve in a way that you can actually FEEL? ARE they dissolving stitches?? Pleeeeease tell me you don't have to go back and get them actually pulled out!!!

No problem about the questions.

The stitches are more "inside" versus "outside" the lid/punctum area.

They're teeny-tiny. Even under my 20x mirror, they were just tiny black "knots" with ends peeking out.

No one said anything about noticing them. I had to point them out to a few people.

Yikes, no, nothing touched my eyeball. In the past I've had plugs that I could feel so I know that sensation. There was NO jabbing, poking or scratching by any part of the stitches. The doctor was very careful to make sure of that. I'm sure your doctor will be careful too.

Sorry, yes, the stitches need to be removed ~10 days later. The inside part dissolves, but the knot must be cut and taken out (unless it falls out on its own for some reason). But don't worry - it doesn't hurt *at all*. There is no tugging, no pinching, no "oops, I gotcha", no pain, no anything. It felt like a light brush. Really! I was scared too but know now that it's a breeze. The worst part of your whole experience will be your imagination running wild!

[Guest]

The stitches are more "inside" versus "outside" the lid/punctum area. They're teeny-tiny. Even under my 20x mirror, they were just tiny black "knots" with ends peeking out.

Super! Glad to hear it!

Yikes, no, nothing touched my eyeball.

Whew! More good news!

Sorry, yes, the stitches need to be removed ~10 days later. The inside part dissolves, but the knot must be cut and taken out (unless it falls out on its own for some reason). But don't worry - it doesn't hurt *at all*. There is no tugging, no pinching, no "oops, I gotcha", no pain, no anything. It felt like a light brush. Really! I was scared too but know now that it's a breeze. The worst part of your whole experience will be your imagination running wild!

Ok... bummed that anything needs to be removed, but happy that it didn't hurt. So the worst of it is the inconvenience of having to go back... ok... I can live with that!

Thanks sooooooo much for the info!