Amniotic Membrane Surgery

[Rebecca Petris]

Jeez, Joey, after all you've been through, I'm really sorry to hear this.

In addition to the usual Schirmer, TBUT, staining, I would ask for meibography.

[Joey]

Hi all.

So I got the round of tests done on Friday at Dr. Tseng's. It seems that my oil layer is good, and I do not have MGD. It is my water layer (aquious?) that is not good. My left eye is slightly better then my right.

So, to decrease the inflamation, Dr. Tseng injected me with Kenelog shots in both eyes. He also put one more punctal plug in my right eye. (Right has 2 and left has one.) Then he put in these really large contact lenses in, that cover most of my eye. He said that this will help to keep the tears in my eyes longer, instead of having then run out of my eyes. The last thing he did was the Autologous Serum Drops. They took out 12 viles of blood!!!

I am going back to see him on Monday morning before I drive back to Orlando, for a quick check up. So I will post more after then. As of now, my eyes are ok. They may be getting a little better. They aren't as dry, that's for sure. The redness is still there, though. Hopefully this will take the inflamation down. So, keep your fingers crossed and say a little preyer for me

[dianat]

Will do Joey. Keep us updated...we're all watching.

[Joey]

Hi everyone,

So today I saw Dr. Tseng again. He put another punctal plug in today. My left upper tear duct. So I have all 4 plugged again. I keep going from having them plugged to getting them taken out to back in. Geesh! So he said that the next time I see him he will express some of my oil glands. I guess I do actually have a couple that are "constipated". (Those were his words ) So my eyes are back to being wet, but thee tears aren't running down my face constantly. The redness is still there, but it might be getting a little better.

That's all for now. I guess I wait another month and go see him again. Hopefully this next month my eyes will improve a lot.

[Joey]

So far so good. The redness is going down, but there still is an overall pinkish tint to my eyes. The large contacts are a bit uncomfortable, but I am trying to deal with them. Sometimes my eyes are really teared up and the contact moves around. And then sometimes it feels like I have some gritty stuff in my eyes, and then it goes away.

That's all for now. A little beam of hope for now.

[np1981]

Seems a while since we got some updates, whats the latest guys?

[Nikki]

update

Hi,

it's been about 2 months since my excision of chalasis (lower, bilateral) with Dr. Tseng. Eyes feel considerably less dry - that's the good thing. Do still have some redness (inflammation?) in the lower left eye. Have tapered off of steroids, per Dr. Tseng.

Apparently, I still have blepharitis, mgd, plugged oil glands, and some meibomian gland atrophy. am on doxycycline, restasis, warm compresses, and use usually systane, pf disposable eye drops. Have experimented with systane free, soothe, refresh endura, without much success. omega 3's are pointless now, despite trying them, as the glands are plugged shut.

I go back to have my oil glands expressed in 2 weeks - hopefully, this will help. Am using all-trans retinoic acid from Dr. Tseng, which is supposed to help unplug the oil glands. Note, this is the isomer of Accutane (cis retinoic acid) and does not cause atrophy of the glands.

From my brief research into the effects of all-trans retinoic acid, it helps to reduce the keratinization of the meibomian glands that may occur with plugged glands. I don't know if it helps to bring back atrophied glands or not though.

hope others are doing well.

Scott

[np1981]

Hi Scott,

I go back to have my oil glands expressed in 2 weeks - hopefully, this will help. Am using all-trans retinoic acid from Dr. Tseng, which is supposed to help unplug the oil glands. Note, this is the isomer of Accutane (cis retinoic acid) and does not cause atrophy of the glands.

From my brief research into the effects of all-trans retinoic acid, it helps to reduce the keratinization of the meibomian glands that may occur with plugged glands. I don't know if it helps to bring back atrophied glands or not though.

I too, was told that some of my glands were plugged, and he gave me the same stuff. He reckoned from expressing them, that 50% of them were working in one eye, and only 30% in the other (which feels worse too). How long did he suggest you use it?

I am more and more convinced that the root cause of my eye problems is lid disease (causing MGD etc). I'm still doing the tea-tree oil scrubs on my eyelashes, they have definately helped.

[Joey]

Hi Everyone,

Sorry it has been a while since I have posted. I just purchased a rental property, so I am trying to get that fixed up to rent out. So that is sucking up most of my freetime.

About my eyes, well... they are not as red as they were before. They are still pinkish though, but are improving. I am still using the autologous drops. Not sure if they are helping or what. I stopped using the large contact lenses about a week ago. They were really starting to bug my eyes. And with all the condo renovations, I just couldn't deal with them. My right eye seems to be a little worse then the left.

Then strange thing about my eyes now is that they are not tearing as much as they were before. But they are tearing just enough. I still have all 4 tear ducts plugged. But the thing is that they were over tearing before, and that is why we put the large contacts in.

So I go to see Dr. Tseng on Dec 26th. Scott, when do you go? Maybe we could meet up if it is around the same time.

Take care all!!
-Joey

[Joey]

Update... 5-6 months post surgery

Hello everyone. It seems like things sure have quieted down on this post I hope everyone is doing well. I am doing ok. I finally have my free time back. So let me start off by writing about my last visit with Dr. Tseng and then I will keep you guys up to date on what's going on now.

I saw Dr. Tseng on December 26, 2007. At this point, I was off all medicated drops and steroids. I had used the large contact lenses and the serum drops. Dr. Tseng was pleased with my improvement but still was concerned with some of the inflammation that was going on in my eyes. (My eyes were still very pinkish colored.) He injected me with a shot of kenalog in each eye. I still had a crescent shaped scar area in my right eye. He said that was where my old tissue was forming with the new tissue. He suspected that would even out. (The thing about Dr. Tseng that you will notice is, he is very careful to not say thing like "that will" or "definitely". It is more along the lines of, "suspected" and "should". He is very careful like that.) I was still skeptical. I noticed that my eyes weren't burning so much anymore, and that is really the only major improvement since the surgery. My eyes were still pinkish colored, but that is what they looked like before, too. Are they any better or worse? Well, it's hard to say. Somedays I feel like they are and somedays not. All of the major redness from the surgery is gone, but the underlying redness/pinkish is still there.

He said to just use up the serum drops and not to refill them. I was also to discontinue the large contacts, which is good since I lost them He then said that I could wait to come back to see him, and basically this may be as good as it gets. He said that some peoples eye are just redder then others. It has to do with the oxygen feeding into the eyes, or something. Also, he believes that the over-tearing noted before was "reflex tearing" or "emotional tearing" triggered by the dryness first on the cornea. Now with large contact lens that shield such dryness, the over-tearing disappeared. However, since my last visit, a little more over-tearing has returned.

So on to how I am doing now... I am pretty much the same. The red/pinkish color is still there. I think the kenelog shots do help. I think I might need to get some more shots. The crescent ridge area is going down. My eyes feel comfortable, for the most part. Some minor burning has returned in the left eye. They are only dry when I wake up in the morning. I do get some over-tearing throughout the day. Somedays I feel hopeful and some days hopeless. Things could be a lot worse, right? I guess it's just that I had such high hopes for this surgery, and it didn't fill my expectations. I have heard people say it before, but this surgery is not the miracle cure all. I didn't really have to pay that much for the surgery, so I kind of lucked out in that department. But if you have to pay out of pocket for it, I would strongly recommend doing a lot of research before investing your money in this surgery.

That's my thoughts. I hope everyone is doing well!

-Joey

[np1981]

Thanks for keeping us updated Joey.

Nik

[np1981]

Any more updates from you guys?

[Joey]

Update, April 2007

Hi everyone,

So here is the latest...
I wish I had better news to report, but that is not the case. My eyes are not doing so well. They seem to be worse then from before the surgery. My eyes are still red and inflamed., they burn someimes, and my eyes still have cresent areas that are raised.

Dr. Tseng now things that my M. Glands may be the problem. Now I am trying Restasis and Vitamin A ointment. The ointment reallly burns my eyes, so I stopped that for a couple days. The only way my eyes clear up nicely is with the steroid drops. But I am not using those now.

Honestly, I am sick of trying these new things!! I am not 100% convinced that this surgery was the best thing for me to do. I am not 100% convinced in this surgery, either.

I am supposed to go see Dr. Tseng in a couple weeks/months for him to evaluate my M. Glands. I don't really know what to expect.

Hope everyone is doing well!
-J

[np1981]

Thanks for the update Joey.

So do you think you were better off not having the surgery at all? Has it not helped even a little? Its worrying that the surgery seems to have made no difference. What did he make of your M glands?

Nik

[Joey]

Hello everyone, it has been a couple of months since I have posted about the AMT surgery. Unfortunately, I do not have any good news to report. I have gotten the surgery almost a year ago. I have NOT seen any improvements in my eyes since before the surgery. My eyes seem to have even gotten a little worse. I am still going to see Dr. Tseng every once in a while. He is not really offering any kind of help. He is giving me steroids, which I have to buy from his office. Before that he said that it is probably my M Glands that are giving me problems. Then this visit, he said my M Glands were ok and that it was me not blinking.

He just keeps on giving me excuses about why my eyes are not any better. He actually told me that I may need to change my career and lifestyle. Meaning that I shouldn't work on a computer, eat healthy foods and exercise. I pretty much eat healthy and exercise a lot.

I am at a loss. I think I want to get a second opinion from Dr. ******, but I would have to pay out of pocket for that. I am just so mad that I am not feeling any better by now. Hopefully I can help people re-think the surgery. I have still yet to find anyone who is completely thrilled with the results of their AMT surgery.

Sorry I don't have more positive things to write