Trabeculectomy circumstances

[CTinUS]

Hello, for those of you who have had a trabeculectomy suggested or performed, what are some of the circumstances you have experienced leading up to that?

Currently my IOPs are at 29 and 27 after residing in the teens for many years. I'm 53, I take three sets of eye drops (and have taken different types since being diagnosed at 16), and I have had one laser treatment that didn't end up lowering my pressure. My visual field tests are not bad.

I have heard that surgeries often have to be performed repeatedly over the years, so I don't want to start on the surgery merry-go-round sooner than necessary. Looking forward to hearing at what point trabeculectomy is recommended for others.

[JanD236]

I’d been on drops since my 40s and then had laser treatment which only gave lower pressures for about 6 months. I can’t remember my pressures but I think in the region of 16-20 during those years.

Around about your age my fields tests started showing a decline and my consultant suggested a second laser treatment. I decided to have a second opinion and went to Moorfields for this.

The Moorfields consultant changed my drops regime a couple of times, monitoring me after a few weeks of each change but the fields tests showed I was losing sight. A second laser treatment wasn’t appropriate (I was too young and it would have to be repeated too many times over my lifetime which my eyes wouldn’t withstand).

I was given a trabeculectomy on my worst eye and remained on maximal eye drops (cosopt and monopost) in the other. That was about 8 years ago and my sight and pressures have remained fairly stable ever since. In the eye with the trabeculectomy it’s usually 8 and in the other eye it’s 12-14.

I haven’t heard any suggestion that I’m likely to need further ops on the eye that’s already had the trab although it’s likely that eventually I’ll need one on the other eye.

I think I have normal tension glaucoma as at worst my pressures were only ever low 20s. I do have low blood pressure and I think that’s a contributing factor.

With pressures as high as yours I’d definitely be wanted very frequent fields test to make sure that my sight wasn’t being damaged.

[CTinUS in reply to JanD236]

Thanks for your post. That's good to hear the trabeculectomy helped with your pressures and that you haven't needed a repeat trab yet. Also very helpful to know what someone else has experienced leading up to surgery. I hope your pressures remain stable.

[Hidden]

30 years ago I did not know I had Glaucoma. When the optician diagnosed it, the pressure was so high, I had trabulectomy & both eyes were operated on within 3 days. 15mths ago the trabulectomy no longer worked, and I was prescribed 1 XalaTAN eyedrop in each eye when I go to bed on a night. Although I was concerned about this, my eye pressure is in the teens, and all seems well at the moment

[CTinUS in reply to Hidden]

Thank you for your reply. That is a lot to go through all of a sudden -- two surgeries within 3 days! I hope the eye drops continue to help since the trabeculectomy was no longer effective. I took Xalatan for a number of years and that medication worked well.

[eyesong in reply to Hidden]

Reply to overend, I was diagnosed 30 yrs ago Open Angle Glaucoma, had 2 laser surgeries (the solution at the time) neither helped. Then Xalatan given for 20 years worked good. Now I try to avoid surgery after a laser treatment 5 years ago didn't work. I take preservative free drops Cosopt 2 x a day and Zioptan at night, Methazolamide 50 mg pill 2 x a day and use a cream on eyes at nightime Erythromycin to prevent inflamation. Anything to avoid surgery. I am curious the many surgeries I see on this Forum and I hope they have long term success. I wish they could insert Stem Cell therapy in those surgeries to promote real miracles. Eyesong

[Joanne324]

My pressure was fine up until last year, controlled by Cosopt and Lumigan, then suddenly in January of this year the pressure went up into the 20's. We gave laser surgery a try, but it didn't help, so ended up doing a trabeculectomy on both eyes (February and June), and pressure is back to 9 and 10, so both were successful. Surgeries went fine, everything was good, but one eye is very watery now, and dull pain, doctor says that is from scar tissue (the one in February). Visual field test has stayed the same over the last 10 years or so. Doctor has not mentioned any future surgeries.

[CTinUS in reply to Joanne324]

Thank you for posting. Happy to hear it went well for you but for the dull pain and watery eye. I hope that improves.

So far my pressures are back down and holding at 19 to 20, so there is discussion of trabeculectomy only if those numbers rise. The thought of that surgery makes me apprehensive so it’s wonderful to hear of its success.