Corneal Edema Gone for now!

[mgshutterbug]

I have EBMD as well as DES, and nerves to lacrimal glands severely injured by neurosurgery. I did have pretty substantial corneal edema, my vision was very blurry, I was getting a lot of corneal abrasions, had erosion of cornea. I have been using Muro 128 drops and ointment religiously for 5 1/2 months, and edema is finally gone. I got the ok from my ophthalmologist yesterday to get refraction exam, did so today, and got substantially different rx than I have in my old glasses, which I'd only had for about 9 mos (pre-neurosurgery, pre-severe onset DES and EBMD). So now, once I get my new glasses, will be able to see substantially better than I am today! Because of all that is going on, my vision still won't be perfect, of course, but it'll be a heck of a lot better than it is now!

That's my great news!

[liz56]

I'm glad to hear that your edema is gone. That's great news.

Thanks for posting about visual acuity with the combination of DES and EBMD. I have the same problem. Muro 128 5% did not help me in the long term, but Dwelle does. I do have a terrible astigmatism in my right eye due to a rather large area near the bottom of my cornea in which the edema is quite persistent and stubborn.

Please post how your vision is with your new prescription. I'd love to have some advice to share with my optometrist, who said that he cannot correct for the astigmatism in my right eye, which makes life rather difficult.

Thanks,
Liz

[mgshutterbug]

DES and EBMD

Liz,
Thanks so much for your quick reply. I asked my ophthalmologist if I could start using Sochlor 5%, and Dwelle. He hadn't heard of either one, but said if the Sochlor was the same as Muro then it was not a problem. The Dwelle will be tried too, and I'll see how I do. So many people have written in such good things about Dwelle, that I'm really encouraged that it might also work well for me.

So I am advertising the Dry Eye Talk, Zone, Store. The ophthalm. wasn't overly interested, didn't write anything down, but my optometrist did - wrote it all down, wants me to get back to her re: how they work, and how my 7eye glasses work (sunglasses, and transition to wear at nite and indoors). I'm getting rx put in both of them. Will let you know how it all goes.

Maria

[liz56]

Hi, Maria.

I would make sure you check with your doctor before combining Dwelle with Muro 128 5%. Muro 128 5%, Dwelle, and Dextran 10% (available only by prescription) all do something fairly similar to each other. Staying on a course of treatment is really important with this condition, because it takes time to heal. (It took me almost a year to solve the problem, and I still have to manage it.) Swapping out various drops before you give one a chance to work might undermine your progress, and, thus, compliance with the healing process that was under way. In other words, changing drops before you really know what one can do for you may give you false results.

I would say that if your doctor has you on Muro 128 5% (which is the same as Sochlor, just a generic of Muro), then stick with that and discuss with your doctor Dwelle as another possibility down the line. In the meantime, your doctor can familiarize him or herself with the product.

Here's a description of how Dwelle works from Dr. Holly who invented it:

Elevated Oncotic Pressure/Complete Wetting

The magnitude of the oncotic pressure of various, commercially available, artificial tear substitutes have been directly measured by the means of a Wescor Colloid Osmometer.8 One artificial tear, Hypotears® [IOLAB Pharmaceuticals], appeared to create an initial oncotic pressure high enough to supersede the imbibition pressure of the deturgescent corneal stroma. The authors8 assigned the exceptional patient acceptance and apparent efficacy of HypoTears® to its high oncotic pressure even though the relatively low polymeric content of the formulation should not result such a high oncotic pressure at a thermodynamic equilibrium.

Since then, another artificial tear formulation, formulated for the primary dry eye, has been introduced to the market. Dwelle® [Aqueous Pharma] is an artificial tear that has unique wetting properties and a high enough polymer concentration to create a thermodynamically stable high oncotic pressure (65mmHg). The formulation contains three different polymers. Two polymers form a synergistic mixture that is capable of wetting even an intensely hydrophobic surface. The third polymer is present at a high concentration.

In a double-blind cross-over clinical trial against Tears Naturale® [Alcon Laboratories],4 Dwelle® has healed the ocular surface in twice as many patients as the control drop. In an open clinical trial involving a large number of patients, two-thirds of all patients treated with Dwelle® demonstrated complete healing of the epithelium. The remaining one-third also showed a significant decrease in Rose Bengal staining after two to four weeks of treatment.4 The patients also noticed that they could use the drop less often than other tear substitutes. Despite the high polymeric content, Dwelle® has a relatively low viscosity, about 3 centipoises. However, due to the high polymer (solid) content of the formulation, patients occasionally complain of the stickiness or crusting of the eye lids, especially if their dry eye condition is mild. However, when the ocular surface damage is considerable (Rose bengal staining is above 2+), the use of Dwelle® is justified and the patients will tolerate it well.

http://www.dry-eye-institute.org/vit...ml#Article%201

I wish you the very best.

--Liz

[mgshutterbug]

Dwelle and Sochlor

Liz, thank you, thank you. I hadn't realized that Dwelle works similar to Muro 128 or Sochlor. I thought it was a lubricant only, like Genteal. I definitely will not use both Sochlor and Dwelle. But I am switching to Sochlor since it's essentially like a generic for Muro 128, and that is with my ophthalmologist's approval. Thank you so much for the description of how Dwelle works. If the regimen of Sochlor ointment and drops stops working, then it would be time to show my ophthalmologist the thorough description that you wrote about Dwelle. I'm going to print it off now, so I have it.

Again, thanks so so much - and thanks also for your quick response. Your knowledge is a life-saver!

Maria