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PTK - how safe? how successful? complications?

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  • PTK - how safe? how successful? complications?

    I had RCEs for almost a yr straight, then had a hiatus of about 6-8 months with none. They started up again 8 weeks ago. I was in denial for 3 weeks, though I had significant pain and greatly decreased acuity. Finally, I went to a new doc, an OD, and she suggested bandage contact lenses BCL. I have worn them now for about 5 weeks, 24/7. The erosions healed after about 2 weeks, the cornea looked much better after 3 wks. She said the cornea was still to fragile yet, so she said to wear them another 4 weeks to give the cornea a long time to heal well. She replaces the BCL every wk to 7 d.

    Yesterday, I fell asleep on the sofa unexpectedly, and when I awoke, the eye was bone dry, and the scraping of the eyelid helped the BCL to pop out. It looked like a wrinkled, many folded piece of cellophane. I kept using alot of lubrication, even waking up in middle of nite to apply ointment for a 2nd time. Well, of course, when I woke up, I had another erosion, and abrasions. I was also in alot of pain.

    I called Wilmer, because I knew the situation would only get worse. Got the corneal specialist on call, and he was almost distressed to hear that I'd been wearing the BCL at all, much less 5 wks straight, and to continue another 2 wks. He said ulcers can form under them, and it makes cornea prone to infections. He was also surpised that I was not on topical antibiotics with RCEs (when acute). He suggested that since the RCEs were so longstanding, (the 1 1/2 yr total), that he thought PTK was indicated. I said I wasn't too hot on the idea.

    He also said I had numerous microcysts across cornea. He didn't tell me that was from BCL worn 24/7. I did some research on the web, and found some studies which stated that when worn for such long time pds, that microcysts form because of hypoxia from 24/7 wear. I will have to ask my doc whether I had the microcysts before I started wearing BCL.

    Anybody gotten microcysts from 24/7 BCL wear? Could anyone who's had PTK please post? Many thanks.

  • #2
    I have just seen your post above and found it very interesting. My daughter has suffered from RCEs for 2.5 years about once every 3-4 weeks. We have tried a variety of drops, punctual plugs,alcohol delamination and most recently BCLs. She has been wearing these all day and night for a month and then changes them for new ones. This has been for one year. She now has microcysts across her eyes and we are not sure why. The consultant believes she may have Meesmann's, a corneal dystrophy. We were also considering PTK but if Meesmann's is correct, then surgery is no longer an option.
    I have never looked into cysts being caused by the BCL but will definitely research this now.
    Do you know why you get RCEs? Is it in both eyes?