Trab and needling

[Ritualhazard]

Does anyone have experience of needling immediately after their trab? I would be interested to hear how successful it has been. The day after my trab my pressure was 21 but came down to 11 when the eye was squeezed.

It was 12 one week later. The following week it was 16 but again dropped to 12 when squeezed and one stitch came out. It was 16 week 3 but only came down to 13 after the other two stitches came out and a hard squeeze.

By week four it was 22 so I had a first session of needling with a steroid. It was 12 when I left. The eye started spiking (my usual issue) with highs of 34 so by week 5 I had another, longer session of needling with a cytotoxic drug. My pressure is now stabilising between 19 and 24 (two days later)

I’m still on weekly follow ups and taking PredForte 6 times a day. My consultant is upbeat about the chances of success but I’m starting to feel pretty low with all the interventions and continuing high pressure

Any thoughts, information, experiences gratefully received (I have to go through all this again in my other eye 😞)

thanks

[balacakkhu]

Hello, I have had needling after the Trab which needed to be followed up very closely to monitor the pressure, bleb draining and scarring. Like you my follow up included - injections steroid & cytotoxic and steroid eyes drop (started with 2 hourly a day and tailing off over the period of 4 months). It took about nearly 4 months to stabilise and now IOP are well control without any eye drops. Please do not worry you have been monitored closely by your consultant so it should be fine. With best wishes.

[Ritualhazard in reply to balacakkhu]

thank you for your reply. That’s good to hear. My eye is so sore, I’m guessing that’s the cytotoxic drug. Hoping it settles soon

[AlfredV in reply to Ritualhazard]

Probably not the drug. I've had the drug leak out which effectively made me blind in that eye. I did recover my vision but it took several weeks. It was very painful and caused massive swelling around the eye.The soreness is more likely the manipulation and you may be getting irritation from the stitches. Even though your eye may be very watery, you may be experiencing dry eye so do not be afraid to use preservative free lubricating drops which should help.

There's lots they can do post op with a trab to achieve good pressures so don't lose hope.

[Julunder]

Sorry to hear that you are going through needling after your trab operation. My only experience with needling was after an unsuccessful op to insert a stent in my left eye. I subsequently went on to have two successful trab operations with no follow-up needling. Every case is unique and, hopefully, you have a good surgeon who knows what he is doing. Happy to say that my pressures have remained stable for the past 4 years. I am sure you will reach the same conclusion and manage your pressures. Good luck.

[BertWimbledon66 in reply to Julunder]

Hi Julunder,

Do you mind if I ask how and when your shunt failed?

And how longer after was the trab operation? Was that more difficult to recover from than the shunt?

Thank you.

[Julunder in reply to BertWimbledon66]

Dear BertWimbledon 66,

1. I had my first operation on 17th February 2017 (cataract extraction with intraocular lens implantation and aqvesys, also known as xen). Within a week I knew it had failed but it took my eye surgeon longer to accept that it was not working.   Long story that I am abbreviating  because of your question.  It took several months for me to recover both mentally and physically.2.

2. The 2nd operation, on 9th August 2017, at Moorfields Private in London when I had a trabeculectomy on my left eye. I had changed surgeons at this time. 

3. The 3rd operation was on 6th September 2017 also a trabeculectomy on my right eye.

4. The 4th operation was on 25th April 2018 on my right eye and was a cataract removal.

5.The hardest recovery was from the first operation in 2017.   As you can tell I have had a lot of trauma.  Strangely, I see very well and have passed my DVLA tests since then. I still suffer from “dry” eyes, particularly in my left eye. As I said before no two cases are the same.  Your experience will probably totally differ from mine.  At least, I hope so, and you will go on to make a full recovery .

My very best wishes

[Ritualhazard]

thank you. I’m back to surgery for full revision next week 😒