In Los Angeles, Uday Devgan MD is among the best eye surgeons for restoring vision to patients who have had poor results from eye surgery done elsewhere.
Surgery on any part of the body always carries some degree of risk. With an experienced and talented surgeon these risks are lower. If you need eye surgery, be it cataract surgery, LASIK surgery, or something else, it is usually best to have just one surgery that is done well. As the saying goes, “Do it once, do it right, and you won’t need to do it again.”
But sometimes complications can happen during surgery and patients can benefit from revision surgery to correct the problems that happened during the original eye surgeries. Dr Devgan specializes in these difficult revision surgeries to reconstruct damaged ocular tissues and restore vision to patients. Sometimes the surgery can be performing a lens implant exchange if the incorrect lens power or model was originally inserted. Other times microscopic permanent sutures can be placed in the eye to re-center a lens implant, repair the iris, and restore the normal roundness to the pupil.
Some patients are involved in accidents which result to trauma to the eye. Since the eye is so delicate, many of its structures can be damaged by trauma that wouldn’t damage other parts of the body. In cases like these where there is damage to the eye, the accident victims undergo an initial emergency surgery to repair the eye and close any leakage. Then after weeks to months have passed these patients often need a more complicated revision surgery to restore the normal structure and function to the eye. Dr Devgan specializes in these very delicate and difficult surgeries and many other ophthalmologists in California and beyond often refer these challenging cases to Devgan Eye Surgery for evaluation and repair.
Let’s look at a few cases that highlight the potential of what can be accomplished. All of these reconstructive eye surgeries were performed by Uday Devgan, MD, FACS, FRCS. Patients have given permission to use their eye images.
Case 1: Trauma from a car accident
This young man was involved in a severe car accident which resulted in a shard of glass piercing his eye. He underwent an emergency surgery to repair his eye in another state. This helped to save his eye, but the iris and pupil were damaged and his eye was drifting outward and out of alignment with the other eye. This is a devastating injury to the patient in two ways: first, the sight is damaged and second, there is a very poor cosmetic appearance. When this young man is in any social situation, people cannot help but to stare at his damaged and crooked eye. This can be crushing to a person’s self-esteem and can lead to depression.
In this case Dr Devgan had to do two surgeries in one sitting. First, surgery on the muscles that move the eye was done in order to straighten the eye and align it with the other eye. These muscles are under the outer white layers of the eye. Next a surgery was done to reconstruct the roundness of the pupil and repair the brown iris of the eye. This requires a very gentle touch since the iris tissue is extremely delicate. The photo shown here is about six weeks after surgery. As this patient heals more the slight pinkish tint of the white part of the eye will return to bright white. If you look carefully you can detect some of the microscopic sutures that were used to fix the iris tissue – these are very tiny with each one being 5 times thinner than a strand of hair. And though they are tiny, these sutures are made from a very strong and durable material.
This surgery improved this patient’s vision but it also restored his life. He can now be himself in any social situation and no one in the room will have any idea that he suffered from a terrible accident. This patient told Dr Devgan, “Thank you! I’m back to being me again!” and that makes it all worthwhile.
Case 1 – before and after extensive repair surgery by Uday Devgan, MD, FACS, FRCS to repair trauma from a car accident.
Case 2 – Damaged iris and pupil and dislocated lens implant after cataract surgery
This patient is a kind gentleman who had a cataract surgery performed elsewhere in Los Angeles. During the procedure the other eye surgeon encountered some difficulties and there were complications during his surgery. The result was a lens implant in the eye that was decentered and extensive damage to the iris and loss of the pupil shape. This caused the patient to have very poor vision (20/400 vision) with a lot of glare and distortion. After living with this for a year, the patient found Dr Devgan through a referral from another ophthalmologist and he decided that he wanted to have surgery to restore his vision and fix his iris and pupil.
The complex revision surgery involved removing the old, damaged, de-centered lens implant and replacing it with a new, high-quality lens. In order to remove the old lens and replace it with a new lens (what eye surgeons call an “IOL exchange” with IOL meaning intra-ocular lens), Dr Devgan used a special technique to use micro-scissors (as small as a needle) to cut the old lens into pieces inside the eye so that he would not have to make a large incision. These pieces were then removed through an incision that is tiny (about 1/8 of an inch) and the new lens was rolled up like a carpet, placed in the eye through this tiny incision, and then opened inside the eye. Next microscopic sutures were used to repair the damaged iris and restore a round pupil. This surgery resulted in the patient achieving excellent vision (20/25 – just shy of perfect) and a very good cosmetic outcome. The patient, and the surgeon, were both very happy with the outcome.
Case 2 – Repair of complications from a prior cataract surgery done elsewhere with restoration of normal vision and appearance.
Case 3: Cataract Development and Iris & Pupil Damage after Trauma
This patient was injured by a BB gun pellet which hit his eye and caused the brown iris to become detached from its normal position. This is the area from the 4 to 5 o’clock position in the eye which appears to be a black crescent. This effectively gives the eye two pupils: the one natural round pupil and the damaged area. And that gives the eye two images, what we call diplopia or double vision. In addition, the lens of the eye developed into a cataract which you can see as the cream colored tint in the pupil. This patient had poor vision from this trauma with just 20/200 on the wall chart and double vision and glare on top of that.
Dr Devgan performed a combined surgery to restore the vision. First cataract surgery was done to remove the cataract and replace it with a perfectly clear man-made lens implant in a custom power so as to eliminate the need for distance glasses. Then Dr Devgan used microscopic sutures to re-attach the iris to its root and close the crescent shaped deformity. These are invisible sutures that are inside of the eye. Finally one temporary suture was placed on the outside of the eye (at the 5 o’clock position in the ‘after’ picture) to hide the microscopic tunnel incision that Dr Devgan used for the repair. This outside suture was removed after one month. The patient recovered excellent 20/20 vision and has a normal iris and pupil shape as well.
The bottom line is that if you have suffered from trauma to the eye or you have problems from complications of prior eye surgery, there may be hope for you. It can be difficult to find this level of expertise since not all ophthalmologists feel comfortable in performing these types of challenging reconstructive eye surgeries. In Los Angeles, one of the best eye surgeons who specializes in fixing problems from trauma or previous eye surgery is Uday Devgan, MD, FACS, FRCS. If you want to address your particular eye problems, please see us for a consultation to explore your options.