Eye with Oil & Corneal edema already undergone three Operations

Hi,

One of my cousin, a male of 21 years of age got injured in a blast in Feb, 08. His right eye was severely damaged which was later replaced by prosthesis. His Left only eye had Corneal opacity with intraocular foreign bodies.

On 14th March, 08 he underwent PPV with removal of 10 F.B from left eye, phacoemulsification and oil insertion.

On 16th July, 08 oil was removed. It was re-injected on 24th Oct, 08 after a retinal break was found. On 9th Oct, 08 the fundus examination showed macula off retinal detachment.

On 2nd Feb, 09 the findings in left eye included:
- Oil in A.C
- Band Keratopathy
- Optic Atrophy

Left eye chelation was done on 12th May, 09. Mucopurulent discharge with corneal infiltrate was seen on 27th Jul, 09 for which the culture was found to be +ve for staph species. Treatment was given and on 3rd Aug, 09 conjuctival flap and tarsorrhapy was done for left eye. Tarsorrhapy was opened on 6th Jan, 10.

On 9th Apr, 2010 findings included Lt. vascularized C.O + bullae.

Findings on 14th Jun, 10 were:
- Lt subconjuctival oil droplet
- Lt corneal edema & vascularization

He was on treatment for decompensated cornea because of history of BK.

On 5th June, 10 the findings were:
- Pannus ++
- Corneal edema ++
- Decompensated cornea ++
- Pseudophakic

Now he has stuck in a situation where Retinal consultants are of the opinion that they can't operate to remove oil until cornea has been operated since they can't see the oil clearly. On the other hand, Corneal experts are reluctant to operate until and unless oil has been removed. We have been to many experts in the country but still nobody has given us any satisfactory direction. One of the Corneal expert is willing to operate but with no surety of success. So, I would be really obliged if i am given an expert opinion on how to proceed.

Thanks & Regards,
Adil

[Sandy Feldman, MD, MS]

Dear go4adil,

Your friend has a serious situation with a poor prognosis. Nonetheless, I would speak with one of the doctors and find out whether it would be possible for both to assist in surgery. Sometimes, a corneal specialist places a keratoprosthesis at the time of retinal surgery for visualization for the retinal surgeon and then, finishes after the retinal surgeon has done his/her work with a corneal transplant.  I would ask whether this is possible.  I would speak with the retinal doctor first about this option.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[go4adil]

Dear Sandy,

Thanks alot for your concern. I shall be looking forward to your reply. I must mention that i have his documents scanned & placed in chronological order. So, if you want, i can share them as well with you.

Regards,
Adil Raza