Complications S/P scleral buckle surgery

[CMR421]

I am 29 years old and had bilateral retinal detachments.  I had a scleral buckle placed on the right eye on 9/6/08 and a laser procedure for the left eye on 9/17/08.  The left eye has done wonderful after the procedure.  But I am still having troubles with the right eye.  At my 6 month check up they told me that the retina was FINALLY 100% reattached.  But I have been having trouble getting off of the steriod drops.  Every time we try weaning off of them, within days I end up with a flare of iritis.  But being on the drops for so long has caused quite a bit of damage to my cornea.  Is there any other way to stop the vicious cycle of having so much pain from the iritis and causing damage to the cornea?

[CMR421]

The tears that I am currently using are TheraTears.  So doing good on that.  My surgeon had talked about doing an injection, but she was only going to do that if the retina wasn't fully attached at my last visit.  And now that it was, I have been released from her care and now am back in the care of my optometrist (who I actually work for).  He just started me on a different steroid in hopes of lessening the damage on the cornea.  There is a lot of deposits from the Pred Forte and also have some corneal thinning.  There is also a dellen.  What is the name of the new steroid you mentioned?

[Michael J Kutryb, MD]

You're in a tough situation. Some thoughts: Frequent, preservative free artificial tears are helpful. Punctal plugs and oral flax and fish oil might help.  Sometimes a steroid injection by the retinal surgeon can reduce the number of drops needed.  Also, an oral anti-inflammatory can sometimes help in certain cases. There is also a new steroid, that could be stronger than Pred Forte that might be able to be used less frequently.  This is a complex case and I don't know enough details to be more help.  Keep in close touch with the surgeon and hopefully things will turn in your favor before long.

MJK MD