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Corneal Scarring from Keratitis after Superficial Keretectomy.. Nightmare situation

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  • Corneal Scarring from Keratitis after Superficial Keretectomy.. Nightmare situation

    42 yo/male/western U.S
    Please note: I'm not asking for a diagnosis. I'm only seeking discussion, feedback, and opinions (hope) about the situation with my eye.

    I am posting in detail for the first time since this happened to me in November, 2021. I went for what was supposed to be a simple corneal procedure. I received a Superficial Keretectomy to try to solve Recurrent Cornea Erosion (RCE) in my affected eye.

    The day after the Superficial Keretectomy, I knew that something was seriously wrong. I started to feel intense pain. I went to the clinic and the intense pain was misdiagnosed as something else. It was in fact a very serious bacterial infection. The next day or two the infection absolutely exploded, and I was easily in a 10 out of 10 pain. At the clinic, they cultured a piece of the contact bandage lens which of course they had to remove. They found that the infection was an antibiotic resistant strain of Staphylococcus Aureus.

    For any eye doctors out there reading this, I am questioning whether the doctor should have had me on a steroid drop immediately after the Superficial Keretectomy. Is this normal? I have read that steroid drops can cause bacterial infections like this to explode overnight. I also wonder why the doctor did not prescribe an antibiotic that could handle this sort of bacterial.

    Days later after the doctors caught the infection, by then it was too late. My eye looked like something straight out of a horror film. It was almost like the eye disappeared and there was just something red and bloody starring at me in the mirror. The doctors prescribed the "big gun" antibiotics of compounded Vancomycin and Tobramycin. I was instructed to use these compounded drops every single hour around the clock, which meant I needed to set my alarm for every hour, which means I had to wake up every hour to put both painful drops into my eye to kill the infection. I did this for almost two weeks. This was the start of the nightmare. As well as being by far the most painful thing I have ever experienced.

    Fast forward three months later to now. I have been on Prednisolone for over 3 months, and the doctor intends to keep me on it for months more. I am concerned how this kind of use of "Pred" will almost surely quicken the formation of cataracts in the affected eye? I'm curious about any thoughts about this especially from medical people reading this. However, I realize that it is to try to heal any of the scar tissue that we can.

    The deep corneal scarring is located at the direct center in front of my pupil. Which means now my vision is almost non-existent. Outside all I see is whiteness and nothing else. Indoors in very low light, I can only see big objects sometimes.

    Doctor has said I need a cornea transplant to try to fix this. But the doctor describes a corneal transplant as a potentially risky procedure that would require at least 3 months commitment and perhaps in my case a one year or lifelong commitment.

    For whatever reason(s) I have a particular sensitivity to things touching my eye. Needless to say, I am probably the worst person to have to go through this, though nobody should ever have to. I have never been able to wear a contact lens or touch my eye. For the doctor to remove a contact lens from my eye, it takes time and trial and error. Because I tend to blink and instinctively push their hand away. It happens almost as a gut reaction. They did the Superficial Keretectomy while I was under "moderate anesthesia."

    The doctor has some concerns that if he does a cornea transplant on me that if one of the stitches were to become infected, etc. and he needed to get the stitch out immediately that it may be too difficult to put me under anesthesia to have it done. He says he does not want to be responsible again in case something goes wrong. I'm curious about people's thoughts on this?

    I want my vision back. I do not want to do a corneal transplant, but it seems I've been told it would be necessary to do a corneal transplant in order to hopefully have my vision back. Another cornea specialist looked at my eye and said that the shape of cornea is disfigured and there some moderate to heavy scarring at the front center. I never thought I would be in a situation like this. ((

    I do not have permanent housing and since this has happened to me I have extreme difficult working in front of screens or doing normal things. I am really not sure how I can solve this problem that I am facing. I would love to get some advise, helpful feedback, and perhaps some answers to some of the questions in this post. As well as any suggestions about what else I could try which of course I would bring up to my doctor before attempting anything suggested. Apparently the doctor says that PTK wouldn't be an option in my case as well as he has said that I tend to epithelialize slower than average.

    What else can I try to try to improve this situation before trying to do a corneal transplant? The doctor says he wants to wait "at least 3 months" to see whether the corneal scarring improves much at all. Will the three months make a big difference? Because right now and for three months my vision has been beyond horrible. I am also experiencing twitching/throbbing of the eye that started a few weeks ago. I have told the doctor but he says it's "normal." Is it normal to have twitching and throbbing of the eye every couple hours that lasts for a while? There is also still a consistent dull pain, which I am not sure what I could do to improve it.

  • #2
    Hello!

    My heart goes out to you. That is an awful lot to go through. What a very difficult situation.

    First can I say, if you'd like someone to talk with about this, don't hesitate to reach out. (As you've said, for discussion, not diagnosis etc.) Email info@dryeyefoundation.org, or call 800-484-0244. I'm going to be out of town most of the next few weeks but could talk in the next day or two or after I come back. Also we have zoom groups if that would be helpful for some support and practical suggestions on coping (with vision and other symptoms).

    Next about corneal transplant. Did your doctor say what type of transplant they recommended? Did the 2nd opinion cornea specialist talk about transplant options?

    Has anyone that you have seen indicated whether a scleral lens might a possibility for you (both whether it would be safe for you, and if so, whether it would be likely to improve your vision at all).

    When you say "Is it normal to have twitching and throbbing of the eye every couple hours that lasts for a while?" I think of blepharospasm. That might be something you could just call your dr's office and discuss. Some of us get blepharospasm from undertreated dry eye. You don't mention anything about OTC drops so I'm wondering if you use lubricant eye drops and if so whether they help.

    Last, about short term and the difficulties you're having with work. I've had many periods where pain in one eye seriously interfered with work (and yes I'm on a computer very long hours). So I've had to experiment quite a bit with combinations of patching and lubricants and also good care for the good eye to make it all work.
    Rebecca Petris
    The Dry Eye Foundation
    dryeyefoundation.org
    800-484-0244

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