Trabeculectomy glaucoma surgery, has anyone had one?

Tell me what kind of surgery he is suggesting.  All surgeries have names (so they can bill you :O) or at least a description.  He may be suggesting a surgery entirely different than the one i had, so let me know.  I don't know how to interpret 40% field loss.  Does this mean you have acute or closed angle glaucoma, as opposed to wide angle glaucoma?

Hi Beverly i see him again on thurs so will ask what kind of glaucoma i have. He was very concerned saying its severe he mentioned surgery to create a drainage hole?

 

I would have to have more than "create a drainage hole" in order to comment about the surgery.  I would ask him if is a "Trabeculectomy" or something else and if so, what is it called. Maybe it is "needling".  I can give you some info and tips if it is a Trabeculectomy.  The good thing about having the name of the surgery is that you can look it up on the

internet and you can get more info.

thanks Beverly ill be asking him thurs, he said due to the severity of my eye he wants the pressure down to 10 and drops wont achieve that

 

It sounds like you are going to have a trabeculectomy, but just verify for me so i can let you know what to expect.  I assume this will take place in a hospital operating room rather than a clinic.  What country are you in?  I did not experience any pain, i had a local anesthetic and mild anxiety medication in a drip and think i might have fallen asleep for a short time.  This operation takes about one half hour.  I will just say this for now to eliviate any anxiety you might have, but will give you more info when i am sure it is a trabeculectomy that we are talking about here.  Don't worry.

Hi Beverly, thanks so much for your reply!!! im in australia, im worried the procedure will be really unpleasant i think my dr will give me more info thurs. Im only 44 and worried ill go blind in one eye

Don't wait until the doc tells you something.  Ask questions, whatever questions you have re the surgery, ask what kind of anesthesia will be used.  If is a trab., i found the surgery quite pleasant and comfortable and relaxing to tell you the truth.  I could tell when he was making 3 little stitches in my eye (although there was no pain) and asked what was taking him so long. What i found unpleasant was the month that followed the surgery.  I had no complications and no pain, but i was irritable.  If the doc can get the pressure down sufficiently (which he should be able to do), it will stop the progression of vision loss.  Ask him what the chances are that you will loose that eye, and about how long it will take and see what he says.  Your doc wants to save your vision.  That's why he wants you to have the operation.  You should give him and you the chance to do just that, work with him and stop scaring yourself half to death.

Did you watch a utube video of the operation?  No, you don't want to do that, i would never have done that, i am squimish and could not stand to watch something like that, and see?  you have already terrified yourself for no good reason.  I hope the doc will give you some assurances on thursday to ease your anxiety somewhat.  Keep me posted, we are rooting for you .

Hi Beverly, thanks again for your great reply you have put my mind at ease about the surgery im really worried about losing more vision, i can notice the vision loss when i close one eye, and it seems like there are big patches across the whole field that are just starting i think

Hi Beverly can i ask how long you have had glaucoma? have you suffered vision loss? whats the reason for your surgery? thanks so much for your advice, this has been a very stressful time for me

 

Yes indeed, glaucoma can cause stress and worry.  If i understand your situation, all of this came down on you like a brick upside the head.  It sounds like it has taken you by surprise in a very short period of time and it is something that i imagine is particularly difficult to process when it hits you so suddenly.and at such a young age.  I have had glaucoma maybe for a year and a half...possibly 2 years, but i have been treated for high eye pressure (IOP over 20) with drops for the last 10 years, before the glaucoma (i.e. loss of vision cells) showed up on a field of vision test.  I have wide angle glaucoma and i expect you have closed angle glaucoma (don't forget to ask).  I have had some vision loss, but i have not noticed it so much because it is not significant and it is in the part of the eye that is not used very much.  The vision loss is in my right eye, my left eye is normal so far.  Also i have not lost much of my periferal vision.  The reason i opted for having Trabeculectomy surgery is that my vision loss was not being sufficiently lowered by the medicated eye drops.  There are only about 3 types of eye drops that i can use that i do not have adverse reactions to,  I had tried some laser treatment but it did nothing to lower the pressure.  With wide angle glaucoma, i have not experienced any pain during the last 10 years as a result of high IOP and the onset of glaucoma.  I was hoping to wait for the MIGS to be approved in the US and/or Mexico.  MIGS means "minimaly invasive" laser procedures that have been approved in some countries but not others (i can't exactly remember what the G and S actually stand for).  No one can say when the MIGS will be available in the US and/or Mexico, but i didn't want to risk additional cell loss and it may be a year or two before they are approved.  Once i made the decision to have the surgery, i had it done as quickly as possible ...earliest possible date.  I am a US citizen but do not live there, having retired to tropical southwestern Mexico some years ago.  There are very capable doctors here and i opted to have my surgery here rather than traveling to the US for a relatively simple and well known, time tested surgery.  Also, the costs of surgeries and medications is more affordable here...maybe 10 times less expensive than in the US, not to mention i am now aclimated to a tropical climate and any thing lower than 20 degrees C is too cold for me .  Canada has approved the use of MIGS, but oooooh, it gets chilly there.  So my situation is much different than yours because i have had 10 years or so to slowly absorb my situation, and this has taken place between the ages of 60 to 70 which is my current age.  This is not to say i am okay about having glaucoma.  It only means that i have had more time to get used to it.  It has also given me time to go through periods of not wanting to try any more and just quitting, but i haven't done that yet   Worldwide, the research to prevent glaucoma is aggresively being pursued.  Of course once the site cells are dead, they are not going to return.  The research focuses on being able to keep the cells from dying in the first place.  I hope your Thursday appointment goes very well and that you get an early surgery date.  I can give you more info from the patient point of view once i am sure it is a Trabeculectomy you will be having. So keep me posted

 

the dr says my glaucoma is heriditary as my mum and 2 aunts have it. My grandmother went blind from glaucoma i think?  An optometrist tested the pressure 5 years ago and said the pressure was 23 and it was borderline to take drops or not. The specialist said he wants my pressure down to 10

Hi Beverly he said i have open angle glaucoma and i might need a trabeculectomy.

Do you know what?  That is wonderful news, if you can even believe that.  Acute or closed angle glaucoma is more severe, and can be painful. IOPs can soar into the 70's.  So, i believe open angle is much easier to control.  Re the trabeculectomy, this surgery has been around for quite awhile, and has a high success rate.  It is well tested rather than being experimental.  I am the world's biggest baby when it comes to most things medical but i was very relaxed during the surgery.  I was given a drip with a mild dose of a relaxing drug, and local drops to numb the eye. Although the operated eye is held open with some apparatus for that purpose, you cannot see anything other than a yellowish light, but not the light fixture, not the instruments or the people.  I did not experience pain before, during, or after the short surgery which only takes about a half hour to 40 minutes.  As soon as i was rolled out of the operating room into the recovery room, i was ready to get up and get dressed, but hospital rules required i be watched and remain put for between 2-4 hours.  My eye was patched, i got dressed after about 30 minutes, went down to pay the hospital bill, had an appointment with the doc, and left the hospital.  Sometimes people get infections, but i was given antibotics drops and antiflammatory drops, and a hard, clear plastic eye protector to keep the eye safe during sleeping.  The eye patch can be removed as soon as you get home.  I expect that post-op instructions vary slightly from doc to doc.  The first two days are critical...no reading, but watching TV is okay, then after so many days you don't have to sleep with the clear plastic eye protector any more, and after 1 week there will be an appt with the doc to check pressure and look for signs of infection, etc. and after 2 weeks, there will be a little more freedom, and after 3 weeks or 4 weeks the stitches will be removed in the office, then home with another patch, more antiflammatory and antibotic drops.  This was pretty much my routine but as i say docs will provide post op instructions that will vary somewhat.  There will be some ways to prevent scarring, some kind of procedures to keep the bleb draining, possibly digital manipulation by the patient, or some other method. Ideally, the bleb should drain itself but i have a feeling that this doesn't happen very often.  During the operation, you will receive a bleb (a spongy thing made of not needed eye tissue) and a drainage canal from the bleb, or maybe into the bleb, or maybe both.  This is why i would like to talk to other people who have had this surgery, to compare post-op experiences because they vary, but no one here seems to have had the operation so i will check out some other forums until i find some trabeculectomy post op experiences.  I wasn't impressed with the digital compressions although some people may think they are super. There are too many unanswered questions regarding the digital compression procedure.  Now i have a doc with an entirely different routine and tomorrow i find out how successful it will be, or not.  If you have any other questions "from a patient's point of view" re this operation, let me know.

 

Hi Beverly, thanks agin for your great reply you have put my mind at ease about the operation. How does your eye feel now? irritated? are you still using eye drops to lower the pressure?

The dr put me on ganforte untill monday to check the pressure again. He said if it doesnt come down to the low teens ill need the surgery

Ganforte, huh?  That is a new one to me.  I have used Timolol but this is combined with Bimatoprost which i am not familiar with.  The surgery will be a piece of cake if you need it, post op was difficult for me and took longer than it should have due to a variety of circumstances, but if your doc is paying attention it won't be so bad, although it is not going to be fun either.  I expect every one has a different experience and a different story to tell.  I hope you will share yours with us when/if you have one.  Oh, by the way, i did have some little pinching feelings in my eye

noticeable but not painful.  This was when the scar tissue was settling in.  You know how the scar tissue heals if you have a small wound to the knee or something?  Then as it heals it kind of draws or puckers the surrounding skin together?  This is the feeling you get if the scar tissue starts to form in your eye.  Good idea to point that out to the doc.  Like i say, it is not painful, only noticeable.

Well, my eye has always felt just fine and it is not red or irritated (although it is plenty red after surgery).  What has made me the most miserable is various reactions from various medications and procedures.  The problem i had post operation was that i didn't really receive the treatment that i needed and my eye pressure was higher after the operation than it was before the operation which is not supposed to happen at all and there was no one addressing the problem.  That was depressing.  The  doctor i have now is addressing the problem and has treated me.  It is 3 weeks now since current doc's procedure and 5 months since the trabeculectomy.  My doc says that the first two months are the most important post op because everything happens within that time period.  There are a couple of common and a few not so common conditions that arrise during that time.  The operated eye may become infected but i was, and most people are treated with antiflammatory and antibiotic drops to prevent the possibility of infection.  I have never had an infection.  Not after the surgery, or the removal of the stitches, or the third procedure that my new doc recently performed.  Another thing to watch out for is that your eye has been attacked (from the point of view of the body) and the body is rushing in to heal the area attacked, scar tissue can form and the bleb can cease to drain properly.  This is what happened to me and my eye pressure increased.  There are anti-scarring medications that can be given at the time of the surgery that will inhibit scarring.  I did not receive that treatment from my surgeon at the surgery or later.  I essentially spent a month just letting the scar tissue surround the bleb.  When i found the new doc, he told me that he would need to do a procedure to open the canal and i asked him if he could do it the next week which he did.  I think that was the 2nd week of November.  He gave me a scarring inhibitor at that time.  I have had 3 appointments with him since that procedure, the most recent being today (Thursday December 1) and i have been maintaining a reading of 6 without use of any glaucoma drops or digital manipulations,  6 is quite low and i need to be protective of my eye because rubbing it could cause the measurement to drop down to 5 which is really too low.  Other than that i feel great and have continued life as usual.  doc wonderful anticipates that the 6 measurement will eventually settle between 10 and 15 and then i can punch myself in the eye if i want to   No drops except for the unoperated eye, no digital manipulations of the bleb, no worries.  Except now the left eye is measuring 19 but that may be a spike.  At any rate i am not going to worry about it and just enjoy life for awhile.

 

thanks again Beverly for the great info!!! i got really worried when my dr said he cant guarantee i wont go blind   if my pressure isnt in the low teens with ganforte he says i need the trabeculectomy.

Doctors don't give guarantees, Mike