Conj resection surgery 5 months ago-eyes still red,sore,painful

[jaysona1111]

I had surgery to resect the temporal tissue regions of both of my eyes 5 months ago. While the blood (sub conj hem) was cleared up very fast within the first few days, it left my tissue purple and veiny that seems to not go away. After 5 months, my eyes look the same as it did 4 months ago. I feel extreme soreness in the area where my surgeon resected my tissue. I feel constant headaches above and behind my eyes. The tissue looks red/inflammed, and feels "raw" and "sensitive" the same way a rash would feel raw and sensitive on your arm for example. If I skip one day of steroids (durezol), my eyes turn back into a dark red/purple color. I obviously do not want to be on steroids enough to develop cataracts/glaucoma; I am on durezol 2x a day both eyes. I have severe MGD, dry spots from a previous PRK surgery, severe ocular allergies. I'm afraid to think this surgery has made my eyes more "vulnerable" to these pre-existing conditions.

[jaysona1111]

Thanks for your response. My doctor told me to go off of durezol and onto Lotemax 2x a day. He also took a look at my retinas and overall eye health and said the increased pressure didn't cause any obvious signs of any major side effects.  

Before surgery, I tried all that (restasis for 1 year, xiidra for 4 months, Toyos IPL, lipiflow, gland probing and expressions from Maskin, supplements, dieting, lifestyle changes, doxy, PRP serum, etc). I've even tried drastic treatments like giving up on all meats and other inflammatory foods. I have visited a dermatologist (for another perspective on my MGD), rheumatologist (everything normal), endocrinologist (everything normal). The only thing that has stuck out was visiting an allergist and finding out I am severely allergic to dust mites (which prompted my doctor giving me ivermectin), oak, and mold. Using olopatadine has mixed results. When my eyes were red before surgery, I would take Pazeo and my eyes would turn 100% white. Other times I would take it, it would have no effect or cause increased redness.

I am at a loss here.

[John C Hagan III, MD, FACS, FAAO]

Well you have seen some excellent people and had had a full gamut of therapy. I'm assuming by supplement you mean omega 3?   I really don't have anything else to add other than if the topical steroids start causing major problems you could see the rheumatologist about oral inflammation suppression (non steroid) e.g. methotrexate, etc.

[jaysona1111]

Thank you for your response. I will definitely ask my rheumatologist and my surgeon about oral anti-inflammation medication. Yes, but supplements I meant fish oil. Also, I have been taking hyaluronic acid as well recently. I never noticed a difference from taking fish oil for 2+ years. Actually... after taking hyaluronic acid for only 2 weeks, I notice a significant difference in how my joints feel as well as my eyes feeling much better; they have a much smoother motility sensation at the back of my eyes. Again, thank you for your responses.

[John C Hagan III, MD, FACS, FAAO]

Yes best of luck. If you ever get any definitive diagnosis please come back and post.

[jaysona1111]

Dr. Hagan. I have visited my corneal specialist. She recommended I try something called "5-FU". My eyes are visibly scarred/vascular red (almost purple bruised colour) and they are extremely painful and sore.

Will "5-FU" help with either the redness or the pain?
Does it come in injection or drop form? Which is more effective?

[John C Hagan III, MD, FACS, FAAO]

I have not used enough 5-FU to comment.

[John C Hagan III, MD, FACS, FAAO]

Well long term steroids is not good. Durezol is pretty strong. 5 months on steroids is a long long time.   You could try weaker steroid like lotemax, you could discuss topical Restasis or Xiidra.  You could try lipoflow treatment for your MGD, you could try MG probe and express.   You could see a rheumatologist to see if you have any underlying auto-immune disease that might cause severe dry eyes and slow healing such as Sjorgren's Syndrome,  rheumatoid arthritis, sarcoid, etc.

[jaysona1111]

Looks like I can't edit my post as I forgot to include my question. My question is: what else can I do? Is it possible this damage is permanent? My surgeon has told me he has never had any of his patients take THIS long to recover. Am I a very rare patient who experiences complications on a rather simple procedure?

[John C Hagan III, MD, FACS, FAAO]

What was the procedure done for?

[jaysona1111]

Procedure was to rid my chalasis. My symptoms pre-surgery were extreme dryness, redness, MGD. I am able to produce tears however, and my glands are still "alive" but clogged. I spent a solid 2 years trying non-surgical treatments and medications before resorting to surgery. Surgeon was Hovenesian in Southern California. I have consulted with Tseng in Miami and Maskin in Tampa. Their only takeaway was to wait a year before any adjustments would be made. Adjustments meaning re-doing surgery, which is something I absolutely do not want to do unless it is 100% needed.