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Just had prokera done

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  • Just had prokera done

    I've been a lurker on this website for a few months. My cause of dry eye is overuse of contact lenses for 10+ years and ocular allergies.

    After trying everything (IPL, restasis, serums, plugs, etc), I decided to get prokera inserted in my right eye for a week ($1200, uncovered by Blue Cross Blue Shield). I had the prokera slim option. When my Dr here in LA inserted the prokera slim, it felt really uncomfortable--not painful. The ring is very bulky and will cause your eye lids to swell due to the massive object in your eye. I could only see cloudy shapes through the prokera, and it caused me to be cross-eyed for the duration of the prokera in my eye. Everyday it was in my eye, my eyelids got itchier, the exposed parts of the eye were red and veiny, I had an excess of tears and mucus. The good thing is that I was waking up without my right eye being dry, however the appearance of the exposed whites of my eyes were always red and inflammed.

    Today, my doctor removed it. It's been about 8 hours since having it removed, and I can honestly say my eyes feel and look the same as before the prokera was inserted: veiny and red in the corners. The pain in my eyes are mostly on the bottom-outer corners, and that is where the redness is as well. My Florida Dr, Dr. Maskin, said I have CCH, which I believe he says everyone has. I do notice the folds in my conjunctiva when I press lightly on the corners of my eyes, but my LA Dr said I don't have chalasis. I'm not sure what to think. The bottom-outer corners of my eyes are red and burn, which is where I see the chalasis. I think I will try to get the opinion of more doctors here in LA, and see what they think about my chalasis.

    For now, I'm just disappointed with the results prokera. I believe it when my doctor when he says a lot of his other patients get success from it, so I believe I have other issues going on that is causing the red and dryness of my eyes.

  • #2
    It can take a few more weeks after the amniotic membrane disolves to get the full effect. I'm surprised BCBS doesn't cover the procedure. Cigna told me it's covered under a specialist copay if I ever decided to get the procedure.

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    • #3
      FYI - Dr. Maskin tells everyone they need surgery for chalasis.

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      • #4
        linguininess how are you feeling now? Im going to have prokera done soon

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        • #5
          0% improvement unfortunately

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          • #6
            Originally posted by linguininess View Post
            my Dr here in LA inserted the prokera slim [...] I could only see cloudy shapes through the prokera, and it caused me to be cross-eyed for the duration of the prokera in my eye.
            Was the Prokera Clear not an option? It is the same membrane thickness as the Slim but with a different construction at the pupil to let you see through the membrane easier but it's new to the market I think. Sorry to hear the Prokera didn't work out for you, I hope your doctor can find another route of treatment.
            Last edited by PhoenixEyes; 19-May-2017, 13:10.
            Sufferer due to Toxic Epidermal Necrolysis.
            Avatar art by corsariomarcio

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            • #7
              I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor, I also have an appointment scheduled with Dr. Maskin as a back up should things not work out. I have been through several eye doctors and even relocated from a dry climate to a humid one in hopes it would give me some reprieve; it didn't. I would really like to know your thoughts on Dr. Maskin. I have been through all the treatments (2 years now) and have never been given a definitive reason for my dry eyes. The most recent explanation I have received is that my actual tears are inflamed which is causing the inflammation of the lids and ocular surface. In the interim, they continue to autoimmune test me. I feel like the doctors are at a loss for a cause and how to treat the symptoms.

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              • #8
                Hi linguininess
                Sorry to hear about it. Am I right that if you have both water and oil problems?
                You have ocular allergies or inflammation?
                If you could be a bit specific, maybe others can share their experience so you can gain more relief!
                My experience tells me doctors are not so helpful - often we need to find solutions by ourselves.




                Last edited by MGD1701; 19-May-2017, 17:54.

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                • #9
                  Originally posted by PhoenixEyes View Post

                  Was the Prokera Clear not an option? It is the same membrane thickness as the Slim but with a different construction at the pupil to let you see through the membrane easier but it's new to the market I think. Sorry to hear the Prokera didn't work out for you, I hope your doctor can find another route of treatment.
                  I wasn't presented with the option of prokera clear. I know there was a prokera verion my dr mentioned but did not recommend: it is the prokera that ships as dehydrated, then re-hydrates it before inserting in the eye. No idea if this is prokera clear, but my dr did not recommend the dehydrated version. It didn't work for me, but could work for you depending on your condition. You will see a significant change if, lets say, you had chemical burns. But for someone like me who has red corners in the eyes and normal to mild dry eyes, I didn't notice much of a difference.

                  Originally posted by Shea2017 View Post
                  I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor, I also have an appointment scheduled with Dr. Maskin as a back up should things not work out. I have been through several eye doctors and even relocated from a dry climate to a humid one in hopes it would give me some reprieve; it didn't. I would really like to know your thoughts on Dr. Maskin. I have been through all the treatments (2 years now) and have never been given a definitive reason for my dry eyes. The most recent explanation I have received is that my actual tears are inflamed which is causing the inflammation of the lids and ocular surface. In the interim, they continue to autoimmune test me. I feel like the doctors are at a loss for a cause and how to treat the symptoms.
                  Again, it depends on your condition. I believe the cause of my dry eye is from allergies. Allergies to dust, mold, and whatever ingredient it was that my contact lens was made with. My eyes are hypersensitive to bacteria and general environmental dust and particles that my being in a humid or dry environment had no affect on me. I've seen dr maskin and I will say that he is very quick to give a diagnosis and even quicker to perform treatments and surgeries. For me specifically, he did not help me. I'm not saying that he isn't a good doctor, but because my cause of dry eye is fundamentally engrained in my body. My body has allergic (non severe reactions, just annoying reactions) to pretty much everything I come into contact with. If you have an extra $10,000 laying around, then go see Dr Maskin. If you've been doing treatments for over 2 years now, chances are that Dr Maskin will not be your saving grace.

                  Originally posted by MGD1701 View Post
                  Hi linguininess
                  Sorry to hear about it. Am I right that if you have both water and oil problems?
                  You have ocular allergies or inflammation?
                  If you could be a bit specific, maybe others can share their experience so you can gain more relief!
                  My experience tells me doctors are not so helpful - often we need to find solutions by ourselves.
                  100% ocular allergies, which then caused inflammation, which then caused dryness. My osmarity results came back normal. I do have MGD from allergies and using a computer for literally 12 hours a day, which lowers my oils. My main problem is my eyes are over-reacting to possibly everything and I'm just super duper sensitive. I have another dr who prescribed me preservative-free zatidor and I'm hoping I will get some relief from that. Doctors arent so helpful at times because there are 100s of factors that go into dry eyes and it's close to impossible for doctors to consider every single factor. They can narrow it down, but I doubt doctors will find the single root cause of my dry eye. We can only try treatment after treatment until one works. Unfortunately a "cure" for this condition is simply trial by error.

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                  • #10
                    Originally posted by linguininess View Post
                    I wasn't presented with the option of prokera clear. I know there was a prokera verion my dr mentioned but did not recommend: it is the prokera that ships as dehydrated, then re-hydrates it before inserting in the eye. No idea if this is prokera clear, but my dr did not recommend the dehydrated version. It didn't work for me, but could work for you depending on your condition.
                    No idea either about dehydrated version, from this article on the manufacturer's website it sounds like all Prokera shouldn't be dehydrated as it would destroy the beneficial aspects of the membrane so you're right not to go for that.

                    There is a quote on the forum from Prokera's founder Dr. Tseng about how the complexity of dry eye conditions will vary its use, and so I think you're right to pursue the underlying allergies angle. The anti-histamine ZADITOR sounds like a good start, hope you find relief. Is there anywhere you can go to for allergy testing? Have you already started wearing protective moisture chamber glasses?

                    Shea2017: I am very interested in your experience. Not only do I have my first prokera treatment scheduled for next week with my local doctor,
                    As far as Prokera experience goes, it really does vary from person to person I think. I had the Prokera Plus which is double the thickness of the Slim and the same hard ring. My doctor was surprised I was able to tolerate it. I kept the eye closed except to put in antibiotics. I did notice a lot of mucous after a few days but was told this was the first layer of the membrane dissolving / breaking down which looks like mucous. I also did get eyelid swelling the first few days but for me, due to sensitive skin, that seemed to be from the surgical tape adhesive used to keep the eye closed. I fashioned my own eye bandage to keep it closed and the swelling went down.

                    At the time I was experiencing agonizing pins and needles stabbing pain every day in one eye and I think the Prokera helped as a bandage contact lens with added healing benefits. It hasn't cured me unfortunately, my case is complex, but maybe bought me some time until I can try something else like autologous serum. If you don't mind contact lenses you could also try a scleral lens as a longer term bandage lens with added hydration.
                    Last edited by PhoenixEyes; 20-May-2017, 06:17.
                    Sufferer due to Toxic Epidermal Necrolysis.
                    Avatar art by corsariomarcio

                    Comment


                    • #11
                      Hi linguininess
                      We are the best doctors for ourselves, after all we know our conditions better.
                      I just solved morning/mid-night sharp/sudden pain (over-use of ointments recommended by doctors).
                      All 3 doctors confirmed my eyes are free from inflammation - which I suffered for some years.

                      LipiFlow helped opened up ALL the pores - my oil now is still 50% thick.
                      (all 3 doctors just told me Blephasteam/42.5C, 10 min but I hardly had oil feeling)
                      I tried facial steamer which helped my thick oil flow.

                      Perhaps the following could help
                      *Avenova (wipes) - can remove bacterias, use wake-up and before bedtime, avoid soaps.
                      (I use soap-free tea tree oil schampoo)

                      *Blinking exercise

                      *Goji berry (12pcs) + chrysanthemum with 2-300 cc hot water, per day
                      Goji has special substance called trimethylglycine. It also comes with polymeric carbohydrates,
                      which are anti-inflammatory, apart from its rich iron, Vit. A, C (more than beef, carrot and orange).
                      Better use bio quality as most goji are from China. --- 'prevenion is better than cure' my motto --
                      Last edited by MGD1701; 20-May-2017, 10:48.

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                      • #12
                        hey MGD1701, that's great you are free of inflammation I haven't tried lipiflow. In the past, I've used hot compresses which seems to introduce more inflammation in my eyes (maybe due to allergies?). Would you know if someone with allergies would benefit from lipiflow?

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                        • #13
                          Hi linguininess
                          LipiFlow is for MGD/glands issue, like IPL.
                          I think to identify root causes for inflammation and solve it are important
                          otherwise your MGD will only get worse.

                          Lid scrub (x2/day) is very vital for inflammation - to remove bacteria/demodex etc.
                          Maybe try Avenova, BlephEx and reduce Omeg 6, processed food would help?

                          LipiFlow and Blephasteam/42.5C have been proved to be effective/safe, especially if glands are clogged or the oil are thick.
                          Some people find probing first (to deal with scar tissues) is more effective.
                          Last edited by MGD1701; 21-May-2017, 18:47.

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                          • #14
                            Prokera and other amniotic membrane transplants are primarily for treating corneal damage, I wore contacts for years and my eyes certainly dried out faster by the time I had lasik. I have read that prolonged contact use affects the nerve endings in the corneas. It took about 2 weeks for me to notice any improvements in the right eye, the left eye was more immediate. If something else is causing the dryness like mgd or an autoimmune issue Prokera isn't going to fix it.

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