RCE's and Bandage Lenses

[Guest]

DrG,

Thank you for your reply to my post in my ongoing Lasek Dry Eye Saga http://www.dryeyezone.com/talk/showt...2&page=3&pp=20.

The bandage lens is very comfortable although my vision is very blurry with the lens in. When I removed the lens my vision was quite good again I am assuming that my reshaped cornea and contact lenses don't mix.

In my previous post you indicated - "...although I expect the bandage lens to effectively help the abrasion to heal, I am not optimistic about this as a permanent fix, given the doctor's observation."

Do you think that there is merit in persuing this bandage lens option for a longer period particulary at night to prevent further abrasions. I must say that since having Lasek 18 months ago, it is liberating to wake up without fearing an abrasion, my morning dryness is easily sorted with some artificial tears. it is nice also to finally sleep through the night again and not waking up with continual dryness.

I have checked and Muro isn't available here in the UK (as Rebecca suggested). I am using the bandage lens, apply genteal gel to both eyes and put on a tranquil eye mask.

I can arrange for some Muro to be sent over if you think there is merit in trying it.

I am booked for debridement on Thursday should there be no sign of improvement over the past three weeks, however I am more inclined to take a conservative, preventative approach rather than jumping in for an invasive debridement.

I am not shy to ask my DR for a supply of bandage lenses if you think that they will help improve my long term situation.

Cheers

Ian

[DrG]

Ian, I'm sorry I missed your question. My habit is to scan the board from time-to-time, and if I see something that seems directed to me, I jump in, however infrequently.

The bandage lens is not meant for vision correction, but to provide a protective barrier under which the epithelium can heal itself without being disturbed.

The purpose of the Muro 128 is to make a better bond between the epithelium and the stroma, as well as to prevent any more "sticky" episodes between the epithelium and the eyelids. Once the epithelium is healed, then the contact comes out and the Muro goes in.

As you were scheduled to undergo debridement, how did that go?

[Guest]

DrG

Thanks for your reply.

I didn't have the debridement - favouring less invasive options at the moment.

I have a supply of bandage lenses to wear in my right eye of a night. Put a new lens in every night, take it out during the day so I have relatively normal vision now.

Dr indicated that microcysts (??sp) are fewer than previously so is happy lens appears to be working.

Will continue bandage lens of a a night for the next month then another review.

Rebecca has sent some Muro so will try that also when it arrives.

Thanks again.

Ian

[Guest]

DrG

I have my monthly checkup tomorrow and it seems that Debridement is back on the agenda.

The two Dr's that I have seen favour this, they both believe that the epithelium has a better chance of reattaching itself after debridement than it does pursuing the bandage lenses.

I have had some inflammation in my right eye over the past week or so (to the point that I had the Dr rule out infection) and it doesn't seem as though the bandage lens is doing a lot to help with the microcysts - as you predicted.

I am scheduled for Right eye debridement for Friday 11/05, as my left eye is generally OK, I am hoping that my right eye will soon be alot better.

Is there anything that you can recommend (vitamins, drugs, bandage lenses, etc) that may assist me and my epithelium becoming better acquainted this time around.

The procedure has been explained to me (sounds very similar to my epi-lasek except no laser), the DR has told me it will be extremely painful for 3-4 days but other than loads of rest and an ice pack, there isn't a lot I can do about it.

I will also be wearing a bandage lens for 4 days, but I am going to ask about having another one fitted for a longer period if there is any possibily this will assist with the healing.

I have read that debridement works in about 90% of cases, is it possible that this could make the condition worse or is the 10% just mean that things stay as they are?

Again, thanks for your help I really do appreciate it.

Ian.

[DrG]

Dear Ian,

The procedures for treatment of RCE in order of efficacy are:

manual debridement < diamond keratectomy < PTK (phototherapeutic keratectomy)

I don't think you will be any worse off than before if the debridement does not work. I usually don't have patients keep lenses in 24/7 unless the condition warrants it. My preference for RCE is to use a bandage lens to manage the acute phase, then ointments and drops for maintenance therapy. Many patients do well using Muro 128 for prophylaxis, and those who don't need more aggressive treatment.

I wish you Godspeed on your journey of healing.