Restasis vs. cautherization

[Patty]

Hi all,
I'm new to the blogging world so please bear with me. I thought this would be the best place to get the latest feedback from fellow dry eye suffers. I've had severe dry eye due to Sgjorgens for about eight years now and have been using Restasis for most of that time. It seemed to help in the beginning but the last couple of years I've found it has irritated my eyes causing more soreness and redness. My sinuses also become conjested after using the Restasis (especially my left side). I've tried stopping for a few days and my eyes feel less irritated but eventually the dryness takes over and I begin using the Restasis again. Has anyone had a similar experience with the Restasis? If so have you found relief with something else?
My Doctor has suggested possibly doing the tear duct cautherization but that sounds a little scarry.

[Mawsky]

Sjogrens?

Hi all,
I'm new to the blogging world so please bear with me. I thought this would be the best place to get the latest feedback from fellow dry eye suffers. I've had severe dry eye due to Sgjorgens for about eight years now and have been using Restasis for most of that time. It seemed to help in the beginning but the last couple of years I've found it has irritated my eyes causing more soreness and redness. My sinuses also become conjested after using the Restasis (especially my left side). I've tried stopping for a few days and my eyes feel less irritated but eventually the dryness takes over and I begin using the Restasis again. Has anyone had a similar experience with the Restasis? If so have you found relief with something else?
My Doctor has suggested possibly doing the tear duct cautherization but that sounds a little scarry.

Hi, I had the blood work for Sjogrens and it was neg, but I do have severe dry eyes, with no real diagnosis, I had punctal stenosis (blocked tear ducts) two years ago, and was constantly having tears running down my face, or dabbing with a tissue. so I had surgery to open them, they tryed what they call a 3 snip procedure but was unsuccessful, so had to have a much larger operation, and wore stents (small flexible tubing) for about 6 weeks after, alas my punctums are quite open and were draining fabulously for at least 2 years, I have just recently returned to the Plastic surgeon and we are now looking at permanently closing mine....lots of head lowering and shaking from Doc. If you are not producing many tears I would consider this, when I had the stenosis I had tears running down my face. Now I have not had a cry (with a tear) in about 2 months, I'm so frustrated. They do the cautery in the office and use a local anesthetic, my Doc did my first 3 snip under local, and they put in a topical numbing gel beforehand and didn't even feel the injection, so if its fear of the procedure Don't be afraid. In the end you have to do whats right for you, I think that after trying a few things myself I would definitely do the procedure, I thought that having the overflow tears was awful, but I realize it was nothing like this Dry eye business. Good luck keep posting so we hear how it goes, and what you decided.

[spmcc]

RE: cautery

If you're anxious about cautery, you could try plugs first. There are 7-day dissolvables and 3-month dissolvables. There are also "permanent" silicone plugs.

Your ophthalmologist would first measure your puncta and then insert the best size for you. Often people start with the lower puncta... then sometimes people have all 4 puncta plugged.

Plus are completely painless to insert. And if there is excessive tearing, they can be flushed (or left to dissolve on their own).

It's my opinion that plugs (especially dissolvable) are a best first step for someone who is anxious.

[Patty]

I failed to mention that I did try the punctal plugs about four years ago but they actually kept falling out. I don't think they remained in long enough to know if they actually helped or not.

Thanks for the input.

[Patty]

Hi, I had the blood work for Sjogrens and it was neg, but I do have severe dry eyes, with no real diagnosis, I had punctal stenosis (blocked tear ducts) two years ago, and was constantly having tears running down my face, or dabbing with a tissue. so I had surgery to open them, they tryed what they call a 3 snip procedure but was unsuccessful, so had to have a much larger operation, and wore stents (small flexible tubing) for about 6 weeks after, alas my punctums are quite open and were draining fabulously for at least 2 years, I have just recently returned to the Plastic surgeon and we are now looking at permanently closing mine....lots of head lowering and shaking from Doc. If you are not producing many tears I would consider this, when I had the stenosis I had tears running down my face. Now I have not had a cry (with a tear) in about 2 months, I'm so frustrated. They do the cautery in the office and use a local anesthetic, my Doc did my first 3 snip under local, and they put in a topical numbing gel beforehand and didn't even feel the injection, so if its fear of the procedure Don't be afraid. In the end you have to do whats right for you, I think that after trying a few things myself I would definitely do the procedure, I thought that having the overflow tears was awful, but I realize it was nothing like this Dry eye business. Good luck keep posting so we hear how it goes, and what you decided.

Thanks for the info....It would feel wonderful to have a 'good cry'

[willwork4tears]

I have Sjogrens and used high dose 1% cyclosporin (active ingredient in Restasis) for a while before turning to cautery. The high dose cyclosporin did help. But cautery and Lacriserts have completely given my life back. I couldn't wear the silicone plugs and I found the collagen plugs dissolved too quickly. So a more permanent option was what I wanted. I don't overtear and absolutely think cautery was a wonderful choice for me.

Maybe try getting the Restasis custom compounded in a higher dose first. You can search for my screenname and find threads I started that talk about this.

Or try the Lacriserts....then if those things don't help...I would definitely consider the cautery.

[Patty]

Thanks so much...you've been very helpful

[Patty]

I have Sjogrens and used high dose 1% cyclosporin (active ingredient in Restasis) for a while before turning to cautery. The high dose cyclosporin did help. But cautery and Lacriserts have completely given my life back. I couldn't wear the silicone plugs and I found the collagen plugs dissolved too quickly. So a more permanent option was what I wanted. I don't overtear and absolutely think cautery was a wonderful choice for me.

Maybe try getting the Restasis custom compounded in a higher dose first. You can search for my screenname and find threads I started that talk about this.

Or try the Lacriserts....then if those things don't help...I would definitely consider the cautery.

willworkfortears - I've decided to have the punctal cautery on both lower lids and am scheduled for surgery next Friday 1 April. After reading your 'post-op' posts along with comments from others who have had the procedure I think I need more info from my doctor before proceeding. I have no idea whether he's planning to do the deep or the superficial cautery. Sounds as though the deep is the only way to go. I'm assuming he's planning to do a local anesthethic since there was no mention of pre-op restrictions. I'm somewhat concerned that he didn't discuss any of this with me.
Are you still experiencing any of the previous post-op symptoms you described (itching, pulling sensation foreign object when looking sideways)?

[PotatoCakes]

My specialist has brought up cauterization and I'm very hesitant to do it. Plugs (even though mine keep falling out) are temporary; cauterization is permanent. It may be wishful thinking but I have hope that we will find a cause or solution for my dry eye and if I do something permanent, then I could be causing another problem. It's bad enough I've spent a decade taking Lotemax, which causes glaucoma.

As PP mentioned, find someone who can compound Restasis for you. I didn't realize that was a possibility until recently but I feel like my current specialist has done all he can and my dad (retired physician) found me someone at the local med school who is doing a lot of research. He spoke with her quite extensively and she said that she has found the oil in Restasis causes problems for a number of her patients so she gets it compounded without. The oil may not be your issue but if they can compound it without the oil, they can tinker with other aspects of it and it is definitely worth it before you try something permanent (and def do the plugs before you cauterize).