Visian ICL eye surgery and/or dry eye advice

Hi everyone,

I'm not sure if anyone out there will have a similar situation, since this is a little complicated. But:

Along with the dry eye (meibomian gland dysfunction) that seems to happen with a lot of UC patients, I also am very near-sighted. I've wanted to get corrective surgery for years, but now that I have dry eye (as of 2018), I REALLY want it--I can no longer wear contacts and my glasses are driving me nuts. Lasik isn't an option for me because my prescription's too high (-10.5 and -11 in right and left eyes). There is, however, a surgery called Visian ICL, where they implant a permanent contact lens into your eye. According to clinics, I'm an excellent candidate for this surgery for various reasons: my high prescription, no astigmatism, steady prescription for a decade, etc. However, it's still a little nerve wracking because my situation is so unusual: most ICL patients don't have dry eye or UC, and most are not on immunosuppressive meds like I am.

According to the surgeon I've found, my dry eye shouldn't be an issue with the ICL surgery because it's similar to cataract surgery, which is not typically affected by dry eye. (And ICL, unlike Lasik, supposedly does not exacerbate dry eye.) There's also a low chance of infection because they use topical antibiotics and antiinflammatories on the eyes during the surgery, and I don't THINK those will interact with meds like Remicade and Imuran...

Still... Has anyone out there, by any chance, had this eye surgery after developing UC? How did it go?

And separately but relatedly, I welcome any advice for managing dry eye. So far I've tried MiBoFlow (similar to LipiFlow), heat packs and massage nightly (only for six weeks or so at a time--after that it always starts irritating my eyes), a drop of castor oil in each eye nightly (an ayurvedic salve that does help a bit), Retain eyedrops, and blinking exercises. Still, I'm often in eye pain, and it is so miserable!! I'm looking into Xiidra--it's not covered by my health insurer without prior authorization. There must be SOMEthing I can do to not be in this pain for the rest of my life...

Thanks.
Katie

pdxkatie, do you have dry eye problems in both eyes or just one? Have you seen an opthalmologist? Have you seen a rheumatologist to rule out autoimmune related causes for your dry eye condition?

Things like sjogren's syndrome can cause dry eyes.

Thank you so much for all these posts so far!

Iamcurious, thanks very much for all those recommendations--they might help me, too, so I might try them before my surgery. (The last one, which boosts tear production, won't likely help me, though, because my dry eye comes from lack of oil rather than lack of tears. But the other recommendations might help!) It sounds like you've been through quite a lot with your eyes... I hope your progress with them remains steady.

beave, that's a good question about whether I've seen specialists. Yes to both--sjogren's has been ruled out by a rheumatologist, and it's suspected that my meibomian gland dysfunction is instead simply a side effect of UC, since it's another inflammatory/autoimmune condition. (I also have other secondary conditions, like eczema.) The opthamologist could offer only the therapy of daily heat packs coupled with massage to gently express the oil in my stopped-up oil glands, but I've found that after a few weeks of doing that daily as she recommended, my eyes become irritated and it stops helping. As far as I can tell, there is no consistently effective treatment for meibomian gland dysfunction--like UC, patients just have to try various supplements and other therapies and hope that something will work.

Iamcurious, thank you so much again! I really appreciate the thought you're putting into this.

I did take fish oil omega-3s for several months (perhaps 8?) after seeing the opthamologist, who had recommended this--I should have mentioned that before. I didn't notice any difference, though, unfortunately...

So far, the only certain difference I can see (pun!) is that when I'm on screens for more than an hour or so a day, my dry eye feels much worse. I need to be better about taking breaks and doing blinking exercises, since it's so clear that screens affect me. But no therapies have worked, including omega-3s, heat + massage, MiBoFlow (like Lipiflow), and manual expression of the meibomian glands by a dry eye specialist. Retain eyedrops and castor oil provide temporary relief--but staying off screens has so far been the only thing that makes a long-term, noticeable difference. (And unfortunately, my job is totally screen-based! )

Iamcurious, that DOES help! Thank you so much--I just went and turned on my computer's Night Light! It does feel like it eases my eyes. This is something that had occurred to me to look into before, but that I had kept forgetting when I was actually at the computer. I also increased the font size on my computer to reduce eye strain--anything to help me avoid unconsciously squinting or staring at the screen.

Thanks again!!!