LASIK dry eye, corneal damage etc. - possible resource if one has deep pockets

[quattroboy]

quattroboy Yeah, if cutting the nerves is the only approach he has, then I don't think he can be of help to me either since as far as I know, my nerves re-enervated the flap properly.

On the other hand, he also does some interesting things with PRP as far as I know (ex. injecting it adjacent to the lacrimal glands in addition to providing it as actual eye drops)... so that's also worth keeping in mind just in case it ever becomes of interest.

My textbook has shipped and is apparently arriving tomorrow.

I actually reached out to him for the injections. My UK doc noticed my lacrimal glands looked small or even shrunk.

I sent him copies of my convocal and he came back with the response I posted.

Odd because my doc who did my convocal said the healing looked ok but the nerves were not long enough or dense enough yet.

My lipid layer is around 30. Is this lipi layer enough for all this pain?

I don't know, sorry!

Have you had lipiview?

No... didn't want to spend the money since I wasn't prepared to follow up with Lipiflow afterwards.

[ebi1368]

SAAG quattroboy

I always suspected this nerve pain that you are talking about. My cornea is clear but my eyes are always painful but my doctor always says it is because of dry eye. My lipid layer is around 30.
Is this lipi layer enough for all this pain?

SAAG i think you have rosacea too like me. Have you had lipiview?

I'm looking forward to getting that textbook.

[quattroboy]

quattroboy SAAG - The chapter by Alio is available for free online if you access it from the UK. His idea is to lift the flap and cut the faulty nerves, allowing them to regrow properly. I've talked to someone who this worked for, someone who got worse and someone who stayed the same.

https://books.google.co.uk/books?id=YCdFDwAAQBAJ&pg=PA113&lpg=PA113&dq=cornea l+dysthesia+alio+flap+2018&source=bl&ots=Wuwe2_gGG n&sig=HpVZPrGwVastFcDHESUAsDRF_Ao&hl=en&sa=X&ved =2 ahUKEwim64in5uDcAhUGMuwKHVTGBW4Q6AEwAXoECAkQAQ#v=o nepage&q=corneal%20dysthesia%20alio%20flap%202018& f=false

Yes this is his approach I got the book yesterday.

I've cancelled my appointment for now. Not keen on getting the nerves cut. Will wait to see if my current treatment produces results.

The chapter by Alio is available for free online if you access it from the UK. His idea is to lift the flap and cut the faulty nerves, allowing them to regrow properly. I've talked to someone who this worked for, someone who got worse and someone who stayed the same.

https://books.google.co.uk/books?id=YCdFDwAAQBAJ&pg=PA113&lpg=PA113&dq=cornea l+dysthesia+alio+flap+2018&source=bl&ots=Wuwe2_gGG n&sig=HpVZPrGwVastFcDHESUAsDRF_Ao&hl=en&sa=X&ved =2 ahUKEwim64in5uDcAhUGMuwKHVTGBW4Q6AEwAXoECAkQAQ#v=o nepage&q=corneal%20dysthesia%20alio%20flap%202018& f=false

I can only see pages 113 and 114 (the first two pages) of that chapter, the rest of the text is unavailable in the preview. Are you able to see the entire chapter?

quattroboy SAAG - The chapter by Alio is available for free online if you access it from the UK. His idea is to lift the flap and cut the faulty nerves, allowing them to regrow properly. I've talked to someone who this worked for, someone who got worse and someone who stayed the same.

https://books.google.co.uk/books?id=YCdFDwAAQBAJ&pg=PA113&lpg=PA113&dq=cornea l+dysthesia+alio+flap+2018&source=bl&ots=Wuwe2_gGG n&sig=HpVZPrGwVastFcDHESUAsDRF_Ao&hl=en&sa=X&ved =2 ahUKEwim64in5uDcAhUGMuwKHVTGBW4Q6AEwAXoECAkQAQ#v=o nepage&q=corneal%20dysthesia%20alio%20flap%202018& f=false

And add to that the fact that dry eye itself can cause this if it goes on long enough... so we are even more at risk.

[quattroboy]

Interesting what is the implications of centralised pain?

I'll PM you instead of writing it here.

[quattroboy]

jlalio@vissum.com

I think I ordered the last copy at 38! As a result, it's now on back order, hence the price increase.

Can I ask what was the conclusion about your nerves?

"In my chapter I describe how we treat this syndrome which indeed can be treated in your case. However, I need to see you personally and perform a confocal microscopy study and the treatment can be done immediately. You would need to stay in Alicante for about 4 days in total maximum for the purpose....
With best personal regards,
Prof. Jorge Alio"

I'm very curious if there is something in there that's not easily found online for free.

What email did you use to reach out to him? I tried using the general contact form on their clinic's website, but received no reply.

[quattroboy]

Wow SAAG can't believe the timing here.

I've reached out to Prof Alio in Spain to discuss my post LASIK dry eye struggles.

I passed him copies of my confocal nerve images, this was his response:

"Thank you for contacting me.
You suffer what is called by us post LASIK dysesthesia syndrome. It has been described in the second edition of my book Management of Complications in Refractive Surgery, Springer 2018. It consists in inadequate nerve regeneration in the interface, following the surgery. It is not a dry eye but rather a symptom without dryness in most of the cases.
In my chapter I describe how we treat this syndrome which indeed can be treated in your case. However, I need to see you personally and perform a confocal microscopy study and the treatment can be done immediately. You would need to stay in Alicante for about 4 days in total maximum for the purpose.
With best personal regards,
Prof. Jorge Alio
PS: if you wish to read the chapter of the book you can download it from Springer, specifically that chapter, which is very cheap. I cannot resend it to you because of the copyright transfer is in the hands of Springer.
"

I'm currently looking at downloading the chapter of interest, which currently isn't an option on the second edition. I've been in touch with his secretary and the lack of chapter download is being looked into.

I'm also trying to arrange an appointment to allow him to investigate and listen to his ideas.

I know you are a long-standing LASIK dry eye suffer but have you ever had a confocal?

If you are really interested in this area, typically textbooks are several years out of date.

Totally agree with that, but sometimes they are still useful.