DRY EYES & MGD

Interested wrote:

OE Victim wrote: To InthebusinessnotOE:

How many post laser op patients do you see with MGD who didn't have complaints or problems before?

It seems the good doctor has answered the question by not answering it, leaving us to conclude that the answer is far higher than he would want advertised.

Assuming Dr InthebusinessnotOE performs laser surgery then it would not be in his interests to admit the numbers suffering MGD after surgery who did not before!

Which is why there are NO ACTUAL STATISTICS for prevalent problems caused by this industry!

Firstly before getting so presumptious, Inthebusiness has like many other eye surgeons been away at a conference in the United States.

In answer to your question, I hardly see any patients with an exacerbation of MGD symptoms on whom I have operated. That is because unlike many other providers we as surgeons see our patients in advance and treat them for MGD or choose not to treat them at all. I can only recall one patient who had an exacerbation about 3 months following the procedure. He suddenly got worse and was pretty much under the weather after having a relationship split up, lost weight from not eating and was put on anti-depressives. The latter contributes to dry eye from reduced tear production and his ocular surface equilibrium went into disarray. Intensive treatment over 4 months and he got better.

Finally I can fully appreciate the level of disappointment and in turn anger by many posters on this site. I do believe laser eye surgery is fantastic with the correctly selected patient, treated at all stages by the correct individuals in the correct environment. Unfortunately caught up by the advertising hype and price discounting etc. many have made a less than sensible choice. This does not mean the whole industry is poor. 50 million worldwide have had laser eye surgery. The very vast majority have had great outcomes and are fully liberated. A small but significant fraction have had problems and usually as a result of poor choice of provider.

I have Meibomian Gland Dysfuntion and was told by Sheraz Daya in my visit to him that my problems were caused by the retreat at OE which in his opinion could not work, therefore the wrong retreat was given back in January 2009 and I was on a hiding to nothing from the day I had the retreat.

Does OE care I have been left with these problems for life unless I go private and have plastic surgery advised by SD? After the expense and problems I have endured over the years I don't think I could trust any further procedures

DRY EYES
What can I say! We are all told we each heal differently, given different reasons for having dry eyes.

Well I did NOT suffer from dry eyes before my enhancement with OE in January 2009 but by god do I suffer now!

I have been given different reasons by different experts but I know I never had the problems I have now before January 2009 so can add 2+2 that the dry eyes I suffer from daily resulted from my treatments with OE.

It costs me a fortune for drops which only give relief for 10 minutes+

As for the comment above you only have dry eyes problems for 1 year that's a joke.

Financially I am out of pocket big time for the costs I have incurred since my first visit to OE.

I have been informed that when the corneal flap is created by one of the laser machines this severs the nerves and other nerve fibres connected to the lacrimal glands which functions to create and regulate the tear productions.

Also I have been told when the flap is created by laser it may damage or kill cells like the goblet cells (mucin layer of the tear film) which acts part of the lacrimal glands and found on the lining of the eye.

Further more when the flap is folded, the second laser machine used to reshape the cornea induces radiation that could kill or damage eye cells and eye tissue.

I have read up on blepharitis on the FDA website and other sites. Blepharitis can be caused by the laser machine

Blepharitis (pron.: /blɛfərˈaɪtɨs/ blef-ər-eye-tis) is an eye condition characterized by chronic inflammation of the eyelid, the severity and time course of which can vary.

Blepharitis inflames the eye lids which modifies the lipid oil from the mobioman glands, which causes it to solidify and block the glands which leads to mebioman glands disease.

The tear film which protects the eye (cornea) only works effectively if the 3 layers are working together, if one does not function correctly it could cause dry eyes.

1) lipid oil (mebioman glands)
2) aqueous (tear production)
3) Mucin (Goblet cells mixes with water to create Mucous)

This could be the reason why more and more people are developing MGD via laser.

OE Victim wrote: To InthebusinessnotOE:

How many post laser op patients do you see with MGD who didn't have complaints or problems before?

It seems the good doctor has answered the question by not answering it, leaving us to conclude that the answer is far higher than he would want advertised.

Assuming Dr InthebusinessnotOE performs laser surgery then it would not be in his interests to admit the numbers suffering MGD after surgery who did not before!

Which is why there are NO ACTUAL STATISTICS for prevalent problems caused by this industry!

OE Victim wrote: To InthebusinessnotOE:

How many post laser op patients do you see with MGD who didn't have complaints or problems before?

I appreciate you are presumably a busy man but it would be good to hear your answer.

OE Victim wrote: To InthebusinessnotOE:

How many post laser op patients do you see with MGD who didn't have complaints or problems before?

A question I think many of us who've been seen by an independent surgeon are interested in hearing the answer to!

To InthebusinessnotOE:

How many post laser op patients do you see with MGD who didn't have complaints or problems before?

Response to regrets

This is exactly why a patient should meet the surgeon before surgery day as specified in the GOC guidelines.
This is exactly why a patient should NOT be given details of potential risks ( such as MGD) FOR THE FIRST TIME in the consent form which, in their nervous state, they are required to sign MINUTES before surgery and BEFORE seeing the surgeon.
This is exactly why the surgeon should ensure that all risks have been fully explained to the patient and that that same patient has fully understood the risks and is able to give 'informed consent'. This is a requirement of the GMC.
This is exactly why suitability should NOT be be determined solely by an Optom and 'Counsellor' who,it is thought, is financially incentivised for passing patients for surgery.
This is exactly why Optical Express should be employing the OPTOMs who, according to their marketing claims, are highly trained specialists who should be capable of recognising, and appropriately dealing with, pre exisitng conditions such as Dry Eyes and MGD.

On all these points OE appear to be failing miserably :
Patient meets surgeon minutes before surgery
Patient is given a consent form, for the first time, minutes before surgery
Patient has a brief meeting with surgeon. Consent form not in sight and not discussed.
Patient is not given information in a timely manner to enable him/her to give informed consent.
Patient is passed suitable by the Optom. Surgery day examination by and any discussion with the surgeon is very time limited.
Patients' pre- existing conditions are often ignore by the Optom/counsellor.

Which is why so many people are coming forward to describe problems which are recurring with alarming frequency.
Which is why this forum is gaining increasing momentum!!

Posted by 'Regrets' on MGD thread:

Whether caused by laser eye surgery or not, there can be no argument that DES - MGD if you prefer - is unarguably a frequent result of eye surgery.

There is also a vast difference between using eye drops occasionally and relying on them like a drug addict just to get through the day!

Before surgery I only occasionally used eye drops (preservative free) when wearing contact lenses - usually in air conditioned environments - but did not have a problem with DES/MGD.

Since surgery I'm frequently in agony feeling like needles are being jabbed in my eyes. Every morning I wake up and have to open my eyes very slowly because of the pain.

The real likelihood of this was not explained to me at my consultation. The consent form lists DES as a possible side effect but does not go into further detail or describe the reality of living with dry eyes and MGD.

www.eyecaretrust.org.uk/view.php?item_id=274
• Laser Eye Surgery - dry eye is a confirmed side effect.

www.aao.org/publications/eyenet/201107/cornea.cfm