Cataract surgery and map dot dystrophy

Posted by bobr1040 @bobr1040, Sep 4, 2020

I have map-dot dystrophy in both eyes. Last September I had to have my right eye debrided and the epithelial cells removed after a laser procedure. It was one of the most painful experiences I have ever had. I now need cataract surgery in my left eye and asked my ophthalmologist about having a corneal specialist do the surgery because of the potential problems with my dystrophy. He said that he would irrigate the eye more and make sure it stayed moist during the procedure and that a "general" ophthalmologist with a lot of experience doing cataract surgery would have a better chance of not having a negative outcome with the dystrophy than a corneal specialist. He said corneal specialists were good with corneal transplants but they really did not to as many cataract surgeries as an ophthalmologist with a large cataract practice. My Dr. is no longer doing surgeries but his partners are. Does anyone have comments on his advice or experience with this issue. I realize that I might have problems with the dystrophy when I have the surgery but I just want to hedge my bets with the best choice of surgeons.

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Hi, I’m looking for information on cataract surgery. I also have map dot fingerprint dystrophy and an autoimmune disease. I was caught totally by surprise by the mention of surgery so I thought I’d check in with the experts! Thanks

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I have Map Dot Dystrophy and need a cataract replaced in my left eye. I had a horrible (meaning extremely painful) when I had a yager ablation done on my right eye (also with map dot dystrophy). The DR. I saw about my left eye said he recommended debriding the left eye (i.e. talking off the epithelial cells on the left eye and then waiting 3 months or so before having the cataract done. Given my extreme pain when I had my right eye debrided I am wondering why anyone would have that done voluntarily. I would prefer to have the cataract done with a corneal specialist and try to avoid bothering the map dot distrophy. Has anyone voluntarily had the debridement done voluntarily if it was not causing problems?

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I have Map Dot Dystrophy in my left eye and will need cataract surgery in the next year or two. My local opthomologist (experienced in cataracts but not a corneal specialist) said he would recommend debriding the map dot dystrophy cells first then do the cataract 3 or so months later after the eye had healed. I don't understand why anyone would voluntarily go through that painful debridement process unless absolutely necessary or if something happens in the cataract surgery. Any thoughts or comments. Has anyone chosen to have the debridement procedure if the map dot dystrophy cells were not causing a problem.
bob

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@colleenyoung

Good questions about swelling, Datd2. I'm hoping @bobr1040 @rckj @rwinney or @jdeloia422 might be able to offer their experiences.

Datd2, did you talk to your surgeon about the swelling and what you might expect?

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UPDATE; I had my left eye cataract surgery done [after the extremely painful map dot surgery, during my one week check up, my doctor's partner told me see wanted my doctor to see me and she was order another map dot test to be done before he sees me because she said that the map dot was causing my tearing/swelling and lack of healing. Back I g, get the test, WHICH MY DOCTOR DID NOT EVEN ACKNOWLEDGE TO ME, stated to his assistant that "there is some map dot in Rt. eye and bilateral" blah, blah, blah, I had brought pictures of my swollen eyes, he did not look at them, the said the swelling was because they had to clamp my eyelid to do surgery and he would refer me to the specialist in this area, then told his assistant to "do the best she could" with the prescription for my new glasses. I get the prescription and go pick out glasses, etc. and wait 3 wks. for my new glasses, they DON'T WORK. Weeks later I see the specialist, find my tear ducts are blocked on the lt. eye 25% and 80% on my rt. eye [in the meantime I find my thyroid has stopped working and I have severe hypothyroidism, I am immediately put on meds] I tell her of this and she sets me up for a redo on my glasses prescription and to see the dry eye specialist and then her [same day] and they will figure out how to proceed I finally get my re-do appointment 3 days ago, he has the photos of my last map dot test and the first one done 8 mos. ago, he checks my eyes, and finally tells me that he can not do anything more to help me see better, my tests looked EXACTLY the same and he says I need to see another doctor who is a cornea specialist which is also the dry specialist. That's 2 wks. from now, and then he will decide on a course of treatment. ARE YOU KIDDING ME! This has been going on since my first cataract surgery on Jan. 5th, it's now Aug. 14th and I still have all these issues. HAS ANYONE HAD TO HAVE MAP DOT SURGERY REPEATED???

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@datd2

UPDATE; I had my left eye cataract surgery done [after the extremely painful map dot surgery, during my one week check up, my doctor's partner told me see wanted my doctor to see me and she was order another map dot test to be done before he sees me because she said that the map dot was causing my tearing/swelling and lack of healing. Back I g, get the test, WHICH MY DOCTOR DID NOT EVEN ACKNOWLEDGE TO ME, stated to his assistant that "there is some map dot in Rt. eye and bilateral" blah, blah, blah, I had brought pictures of my swollen eyes, he did not look at them, the said the swelling was because they had to clamp my eyelid to do surgery and he would refer me to the specialist in this area, then told his assistant to "do the best she could" with the prescription for my new glasses. I get the prescription and go pick out glasses, etc. and wait 3 wks. for my new glasses, they DON'T WORK. Weeks later I see the specialist, find my tear ducts are blocked on the lt. eye 25% and 80% on my rt. eye [in the meantime I find my thyroid has stopped working and I have severe hypothyroidism, I am immediately put on meds] I tell her of this and she sets me up for a redo on my glasses prescription and to see the dry eye specialist and then her [same day] and they will figure out how to proceed I finally get my re-do appointment 3 days ago, he has the photos of my last map dot test and the first one done 8 mos. ago, he checks my eyes, and finally tells me that he can not do anything more to help me see better, my tests looked EXACTLY the same and he says I need to see another doctor who is a cornea specialist which is also the dry specialist. That's 2 wks. from now, and then he will decide on a course of treatment. ARE YOU KIDDING ME! This has been going on since my first cataract surgery on Jan. 5th, it's now Aug. 14th and I still have all these issues. HAS ANYONE HAD TO HAVE MAP DOT SURGERY REPEATED???

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well it is now June, 2022, just saw the corneal specialist and he says I have a secondary cataract POC and it will get removed so my vision will be clear again, can't tell about whether another map-dot surgery again, my eye is still swollen most days, I do dry eye treatments but it is just my right eye with the problems. blurry double vision and upper lid swollen so it looks half the size of my left eye.' don't have this surgery since the earliest doctor available was the same one that did all four surgeries, I passed on him. It has been a long two years.

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Hi , what surgery did you get for the map dot fingerprint? I will get abrasio in August.

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@dutchmanmichiel

Hi , what surgery did you get for the map dot fingerprint? I will get abrasio in August.

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corneal scraping, both eyes, he did not get it all so I still have this issue in both eyes, more in right, they were EXTREMELY painful so be prepared, my right never really healed and it was done too soon after cataract, which should have been done after, not before. Good Luck!

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@bobr1040

I have Map Dot Dystrophy in my left eye and will need cataract surgery in the next year or two. My local opthomologist (experienced in cataracts but not a corneal specialist) said he would recommend debriding the map dot dystrophy cells first then do the cataract 3 or so months later after the eye had healed. I don't understand why anyone would voluntarily go through that painful debridement process unless absolutely necessary or if something happens in the cataract surgery. Any thoughts or comments. Has anyone chosen to have the debridement procedure if the map dot dystrophy cells were not causing a problem.
bob

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mine were painful a lot, please do it BEFORE cataract surgery with plenty of healing time in between.

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@datd2

corneal scraping, both eyes, he did not get it all so I still have this issue in both eyes, more in right, they were EXTREMELY painful so be prepared, my right never really healed and it was done too soon after cataract, which should have been done after, not before. Good Luck!

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Thanks. Corneal scraping is the same as Abrasio which I will get. Together with micropunctures. Unfortunately I have no choice. I have repeating erosions which are also very painful every couple of weeks i heard from another patient that he was very satisfied. I already have drops which should reduce the pain after scraping but we will see. They will do only one eye at a time. I have no choice. The current situation is constant lingering with regular erosions. This is also no life for me. I am clinging to the guy that said it was easy and who was verg happy with the scraping. Will keep ypu all posted.

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Hello,

I had the corneal scraping done in the right eye two days ago (Epithelial debridement/scraping (abrasio)).

Before the treatment I received anesthesia drops.

Treatment itself took place in the eye hospital in Rotterdam, the Netherlands.

Had to lay down in what looked to me like a dentist chair. An eye spreader was put into my eye. Somewhat annoying for two seconds after that no problem at all.

A light and camera where on my eye. And procedure explained as follows:

-scraping of the epithelia
-polishing afterwards
-hundreds of micropunctures after the polishing to create little microscars that would help the new to be grown epithelia to stick better.

Operation was performed by a docter sitting behind me.
Epithelia came off easy - to be expected according to the doctor as this is a symptom of MDFD. Some parts did not come off easy and were left.

Did not feel a thing, no pain at all. Just some movement and a white thingy crossing my eye. The punctures I noticed but was no problem at all. I was able to chat with the docters.

After treatment a bandagelens was put on they eye and has to stay in for about a month.

The whole thing lasted about 15 minutes. Prescribed drugs were:
- hydrating eyedrops every hour.
- drops against pain six times a day.
- antibiotic drops three times a day.

Advised where painkillers of my own choice. I still had tramadol and diclofenac and use these now post-operation.

Operation took place around 15:00.
Same day I already had very clear vision. Very bright. Also little marks that I always had in my eyesight (litlle dark spots, hooks etc.) where all gone. Vert nice sensation. No pain at all. Two hours after operation burn started but nipped in the but with painkillers. Good night sleep without any problem.

Second dat also good. No pain. Just following the regime using drops and painkiller pills. At the beginning of the evening sight became blurry (normal, new cells forming). Also eye became pink-ish and more sensitive. Also sensitive to light.

Today, the third day. Woke up better than night before. Light sensitivity gone. Also less sensitive. Blurryness increasing two steps forward one step back. Still no pain. Reduced amount of painkillers.

Now the next 24 hours are still part of the period which can be most painful. But sofar this has been realy easy. Especially when already familiar with MDFD related pains, this treatment really is a walk in the park. Complications can still happen ofcourse and will keep you updated. I am very optimistic. The other eye is due in 4-6 weeks. And 4-6 after the other eye is done too, I can get a good eye measurement for new glasses. Thanks and will update later.

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