another preserflo or wait ?

[mx20378]

for the last few years, until recently, i've had latanoprost controlled glaucoma, worse in my RE, probably because of injury from a retinal detachment and vitrectomy/cryotherapy/gas-bubble repair

a couple of months ago a checkup showed me with a RE IOP of 53mmHg (LE 29) ... so i got a preserflo in the RE (now 15) and more eyedrops for the LE (now 18)

the RE preserflo seems to have worked out well, and now my consultant has offered a preserflo for the LE - but i'm not sure what the sensible course of action is at this point - take the preserflo now, or stick with the drops until they aren't working well anymore (assuming that happens)

on the "don't have it now" side i have:

- i gather that shunts have a limited lifespan, and you can only have so many of them. i'm relatively young (53yo), so perhaps it is better to hold off while drops are working well for me, and save the shunts for later ?

on the "have it now" side:

- i have zero damage in my LE, and i'd like to keep it that way, and the preserflo is perhaps better at maintaining consistently low IOPs than drops

does anyone have any relevant information or insight ?

[Floaters]

In my opinion, you can’t make the wrong decision. The drops are controlling your pressure well and the preserflo does not appear to be as risky as a trab.If preserflo was available in the US, I would not hesitate. My situation is 27/29 pressures not being controlled with drops. If SLT doesn’t work for me, I will be faced with a tough decision. I sure wish preserflo was an option. Look forward to hearing what you decide.

[Toby_from_London]

Hi Mx,

As someone who has recently had a shunt implanted after late diagnosis and losing sight completely in one eye, I understand your dilemma.

My right eye couldn’t be saved but there was no damage to my left eye, however with my IOP increasing rapidly and drops ineffective, I had the same decision to make.

My operation was actually scheduled but then cancelled as my eye pressure on the day was at an acceptable level (for me) of around 20. However with the clinic experiencing a COVID outbreak and a delay to my next scheduled appointment, when I returned to the clinic a field vision test confirmed a very small deterioration in my eyesight and an increase in eye pressure. I took the decision therefore to have the shunt inserted to hopefully prevent any further damage.

I struggled with the decision for weeks so I totally understand your dilemma. I’m not suggesting your IOP will increase in the way mine did but I can tell you that the relief I felt after the operation was immense. I’m still in recovery and nothing is guaranteed, but things seem to be going well so far.

Whatever you decide I wish you well.

[Ritualhazard]

For what it’s worth, I don’t have damage (yet) to my vision but as my pressures regularly spike up to 40 or above despite three lots of drops I’m heading down the trab route. Not an easy decision. Do I wait for damage then go for the surgery? Or do I have it now to prevent damage. My consultant said that the spikes in pressure also had a risk of acute damage due to a bleed so I decided now is the time. As was mentioned earlier, there is no wrong decision. Good luck with whatever you decide

[Floaters in reply to Ritualhazard]

Ritualhazard - are you considering the preserflo option?

[Ritualhazard in reply to Floaters]

We never discussed it, just the trab. Need to look into perserflo