
Hello Doctor. My Mother Is 72yrs Old Last Week She

My mother is 72yrs old last week she develop corneal erosion and was experiencing sharp pain, was completely red, continuous water flow from eye.
History:
In early 1962 she develop glaucoma in left eye, then in 1964 she got keratoconus, followed by cornea grafting 1967, then in couple of years she develop fungus infection post treatment in early 90's she again underwent cornea grafting, however body ejected the transplant and the eyeball become complete blue. There is no vision present in left eye now. However she can see follow the light from different angles.
Now until recently after cornea grafting in early 90s she developed cornea erosion every couple of years and was treated with tropical steroids and eye drops.
Now last week again she had Recurrent Corneal Erosion, with condition listed at the top.
We visited doctor who is MD, DNB Cornea & Ocular Surface who has been overseeing her case from past 15yrs , he advised us to remove the eyeball completely at this stage, and also prescribed moxicip, starlub and applied bandage lens however within 2 days she develop sharp pain so we rushed her to same doctor and he refereed us to a surgeon in different branch, when she met the surgeon he performed checkup and found that lens was missing so he reapplied it and also prescribed Enpred, Vigamox and Cyclopez drops.
She took these drops and now she is feeling much better, seems like eye is back to normal now however bandage lens is still present in the eye.
Meanwhile for a 3rd opinion we visited LVP, XXXXXXX and consulted a XXXXXXX doctor who after checked informed us to continue same three drops and also suggested ASP (Anterior Stromal Puncture) surgery along with large AMT (amniotic membrane transplantation).
My mother again consulted her doctor who has overseeing her case from 15yrs and he informed that ASP surgery is more painful and comes with little results and issue may again reoccur after couple of days, months so best is to remove the eye ball also he informed that pain experienced during eyeball removal surgery is bit less when compared with ASP surgery advised her to only consider removal eyeball instead of ASP surgery.
Hence, now we have some doubts which requires clarification.
1. At this age, can she take up ASP surgery with AMT instead of removing eyeball completely, will it give any results, how long such results will last.
2. When it comes to pain management, Is ASP surgery more painful as advised, against removing the eye ball completely.
3. How long is recovery time for both surgeries (AMT and removing eyeball)
4. Which is the best available option at this stage.
5. Any surgery done on left eye will it cause impact on right eye as well, will it have some or little impact on right eye as well.
5. She does not want to loose an eye completely and looking for best available alternative to keep the eye running, having said that she also does not want to under go multiple surgeries at this age,
>that is undergoing ASP and then if it fails or produce no results again go for another surgery to remove the eye ball or any other surgery.
Pre-existing diseases: She is not diabetic , however has high BP, has kidney disease (Renal parenchyma) stage 1-2 however creatinine is under control, blood urea is just bit high.
Please advise and suggest next best course of action at this stage.
AMT surgery
Detailed Answer:
My dear,
Thanks for sending your query to us.
There is no comparison between removing the eye ball and having any surgery.For a patient the psychological trauma of removing the eyeball is great.Removing eye is a physically traumatic surgery,where Six muscles have to be cut along with optic nerve.
She is at the moment controlled by medication.Continue with medication and if erosion doesn't heal amt surgery can be done and is very rewarding.
This will not effect the other eye.We should aim at a painless eye.Bandage lens is usually placed for few months.
I would strongly advice not to go for removal of eye and go ahead with amt if needed.
Do get back to me in case of any further clarification in this regard.


Does AMT surgery provides relief only for sometime. how exactly does AMT works.
What is the recovery time.
AMT surgary
Detailed Answer:
My dear,
Good of you to get back to me.
AMT surgery my provide good and permanent relief and the results are evident within 3to 4 days after surgery.It gives a natural dressing to eroded outer layer of eye.This over the passage of time evens out the irregularity and heals the ulceration.Though the relief starts in early stage the complete healing takes upto 3months.The results of procedure are excellent.

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