Hi. My mum has had suspected glaucoma for the last seven years and over the last three years as developed cateracts which have made her eye sight worse. She has been advised that there is a heightend risk of making her glaucoma worse if she has surgery on her cateracts.However, from what I have read on this forum, many people with glaucoma have had successful cateract surgery.
Do people feel that the risk is worthwhile and can the risk be managed by treating both conditions at the same time?
Many thanks
Laura
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Laurahales
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I was diagnosed with glaucoma around a year ago; one eye was too badly damaged to save but I have had a microshunt inserted in the other, which has stabilised the IOP in that eye.
My surgeon, who has been excellent, told me that while the procedure can cause cataracts, they can be operated on and that operation was “their bread and butter”, i.e a procedure they carry out regularly without complications.
I know from reading other messages and posts, and speaking to users of this forum, that it’s not uncommon to have MIGS and cataract surgery at the same time. I can’t tell you what decision to make but I think this is definitely worth discussing with your mother’s consultant.
Who? exactly has advise her that the cataract surgery might make the glaucoma worse ?
Unless it's her eye specialist I wouldn't lose much sleep over it; and even if it is, all surgery is a balance of the risk of doing nothing vs the risk of doing the surgery ~ and as to the comparative risks involved in your mother's case ~again only her specialist eye doctor can give proper advice.
I was diagnosed with glaucoma in 2005 ( from memory ) when I was 54. My mother had had it from her forties, so it was no surprise.
I had the same eye Consultant ( at the Royal Sunderland Eye Infirmary ) for about 15 years ( till he retired ) and I had such confidence in him that when my cataracts started to develop I asked him to 'do' them before his retirement.
He made me wait a bit, as he said all surgeons like the cataracts to be 'ripe' before they will do the op : ie they won't carry it out prematurely and certainly not unnecessarily.
He never at any time mentioned any risk of the glaucoma worsening as a result of the cataract surgery.
Which I would have thought he would have done if such a risk exists in general.
They now have cataract surgery down to a fine art and have a LOT of experience with it, such that it is very routine ~albeit there always has to be some theoretical risk of it going wrong ~but I think the percentage risk of that happening is very low, like less than 1%.
What can happen is that there needs to be a laser adjustment some weeks after the initial op ( this did happen to me in respect of one eye ) ~but I don't think this counts as anything going wrong.
On the day I had my first one done ( they do them a few weeks apart ~just in case anything did go wrong with the first op ) it was like a car factory assembly line with around 25 people waiting to go in.
The whole thing takes about 15 to 20 mins once you are called in ; local anaesthetic and you really feel nothing. Not even when the anaesthetic wears off later. There is zero pain.
I always remember while I was waiting to go in, an elderly lady coming out and singing ' I can see ! I can see! ' as if she'd just found Jesus ...... lol.
The bottom line is trust the Consultant : if s/he advises it needs doing ( the cataract/s ) then it does. By all means ask about this alleged risk .
And also ask about the real risk of not doing the surgery.
Then do what the Consultant advises. And be grateful this bit of the NHS seems to still be functioning.
Thank you Rhys. It was the consultant who mentioned the risk but then again, the same consultant now suggests mum doesn't have glaucoma so it is a bit confusing. I will pass this on to mum. I am pleased rhe surgery worked out for you. Thanks for replying
Ive had both eyes done and lost left one as macula odema set in im now blind in that eye i then had right one done and same happened in that eye and left me with very little sight sun and bright lights is a nightmare fir me
I like your mum are awaiting for cataract surgery and was told by my opticians that my pressures may will go down after cataract surgery, unfortunately I have not seen my opthalmologist for year due to delay appointments I will finally get to see one on June 8 so I am waiting news on both should of been this week but they cancelled that one recently, to confirm what he said. best wishes
Hi. I had cataract surgery in December, and a Hydrus shunt inserted at the same time to help the glaucoma pressure. This is quite common I think. I was told that a risk factor for glaucoma if you have cataract surgery is that you have to take steroid drops and these can raise your eye pressure. Initially, when they first suspected I had glaucoma they postponed the cataract op ( I was actually at the day hospital on the list for cataract surgery that morning!) and put me on drops to reduce the pressure. I had the surgery about 5 months later. Immediately after the surgery I had tablets to keep pressures down, steroid drops, antibiotic drops as well as the glaucoma eye drops. This is all standard procedure as far as I'm aware.
hi, I am new to this, however I saw your post and wanted to reply...my late mother had cataracts and glaucoma and had very successful cataract surgery in both eyes which did not affect the glaucoma side of things. When she passed in 2022 she still had brilliant eyesight. I have heard that the cataract procedure is very successful.
another point, I have had 4 separate opinions on my eyes recently as I was not satisfied with a glaucoma diagnosis when two previous specialist consultants had diagnosed ocular hypertension with a ‘risk’ of glaucoma. Another top consultant today explained in detail to me that I have no optic nerve damage at all and that I do not have glaucoma. I had even brought my pressure down from 26 and 24 to 23 and 22 and today it was 19 and 20. I have been undertaking various practices myself with diet, supplements, exercises etc etc and I think something seems to be working. He asked me today what drops I was on and how long I had been taking them as he could not understand how my pressure had reduced, however I have not taken any drops as I want to monitor to see if my lifestyle changes etc make a difference. The point I am making is that different consultants (and opticians) have different views, it is essential I think to get more than one opinion if you can or are able to. I am fortunate to have insurance with Benenden which is not that expensive and they do not ask for your health record in order to join ( May be an age limit) and it then kicks in after 6 months into the policy whereby you can be referred to see a consultant. Glaucoma is not covered however as the eyes are so complex, they do cover cataracts and maybe other types of surgery.
That is really interesting and helpful. Thank you for the response. Likewise my mum has had different opinions from different consultants with the latest theory being that she may not have glaucoma at all.I think a second opinion is vital.
Pleased to hear you are seeing some improvements. Good luck and thank you
Hi Laura, I to am waiting cataract surgery and I have gluacoma for 10 years now, I was told by my opticians that the cataract surgery would lower my pressures, I have an appointment this week on Thursday for a gluacoma check up hopefully and the consultant will decide then what to do with my cataract as well, I suppose we all have different outcomes and different consultants and they don't all tell their patients the same thing it will depend on your eyesight and your gluacoma and there are many types. I was told that my pressures should come down by my opticians after cataract surgery, but the consultant may well tell me something different. Best wishes to your mum and you, hope cataract surgery goes well.
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