Hi!I have a failed trabeculectomy. š¢ Operated June 2022 with pressure of 16. Too high so 2 stitches were taken out and then pressure dropped to 2 and wouldn't come up so had to add a stitch to the bleb going through the conjunctiva. Pressure remained at about 11 for 9 months then then the bleb heal over and closed up! To say the least I am dissapointed but also angry. Was going to do needling, but had to do cataract op first. Did that and now Dr. suggests in the summer a SECOND trab instead of trying to revive the first. If my eye healed too fast the first time why would a second trabeculectomy be any different!? I am not that young ( 64) . Has anyone had a failed trab, a second trab or alternative surgery after the failed one? Thanks! I feel so insecure about this!
Failed Trabeculectomy: Hi!I have a failed... - Glaucoma UK
Failed Trabeculectomy
Hi Stephanie,
Not exactly the same but I had to have my MIGS surgery repeated; the procedure was called a ārevisionā but in essence it was the same operation as the first.
I was devestated when I found out the operation would have to be redone as I followed my doctorās aftercare instructions explicitly, as Iām sure have you. I was almost hysterical. However I had to calm myself down and accept it was inevitable.
While the drops regime was exactly the same as the first time, without the initial shock of the diagnoses and being told I would have to have my eye operated on, it was an easier recovery. This time around the steroid drops are being tapered down much more slowly, and after several months my IOP has remained stable, which is encouraging.
I know itās natural to think āwell it didnāt work before and I was so careful; why should it work this time?ā but please donāt lose hope of a successful outcome.
Thinking of you; take careš
Hi Toby, Thanks for the support. Was your MIGS " redone" meaning redoing/fixing up the first operation or making a whole new one in a new space? My trab is unfixable that's why if I do surgery it's better to start a fresh new one . I think the post op steroid use will be longer as well to prevent scarring.
Hi Stephanie,
Yes, thatās right; a new shunt in a different place. Hope that helps.
Yes that helps to know that sometimes it takes a second try. I think I read somewhere that after 3 trabs one begins to run out of " real estate". š²
Hi - I had a trab done a 2nd time. I'm 70. I had my left eye done 2019 and my right eye done 2020. In 2021 my left eye had healed too much and it was redone and needled as well. My consultant said that when they did it the 2nd time they used a larger needle so the drainage tubes were larger. Since then my pressures have crept up from 8 in left eye to 9 currently, and from 9 in right eye to 12 currently. I attend Moorfields and I trust my consultant knows what he's doing. Haven't had cataracts done yet, but I'm extremely shortsighted and each time this has worsened my distance vision. But if it is helping to save my sight, I have to trust things are better than if I hadn't had it done. Hope this gives you some reassurance.
Hi NewCardinal!Thank you for answering. Your pressures sound great! After all that work! So you have had 2 separate trabeculectomies done in the left eye? Or was the bleb reconstructed and then needled? Like me, was the first one scarred over completely?Did you have the second trabeculectomy next to the first one? A bigger needle sounds advantageous maybe that did the trick for you. Did you have a longer course of steroids post op as well?
Hi Stephanie - the 2nd trab was a revision of the 1st one on the left eye. Some of us just heal fast (a good thing if you break your arm I guess but not when the aim is for it not to seal up!). The bleb is slightly larger now than it was originally; it's not a different one. Doesn't bother me though. The post op steroids were just the same as the first ones. However, I forgot to say, to stop the pressures creeping up and keep the low pressures, after about a year I was back on drops (brinzolamide) twice a day as well, first that eye then the other one as well.
Hi Stephanie -I had a trab in January 2023 healed up in 6 weeks, revision in the operating theatre in March, healed up in 11 days, needling in the consulting room in April healed up in 10 days. So I had an aqueous shunt in May with suture removal 3 weeks later. This is still working but only keeping my pressure to about 20. I think I should have tapered the steroid drops off over a longer time than 3 months and that might have helped the eventual pressure be lower. I know there is more treatment to come but not sure exactly what. I don't tolerate drops at all.
The Paul tube I have was a bigger op than the trab but all the doctors say it is much better for people who scar like me . It is more towards the back of the eye. Looking back at my incredibly stressful 2023 my ability to scar means a trab is never going to work for me., even though I am mid 60s. The aqueous tube is the only way.
I would talk to your consultant about a tube operation, it is so stressful having a failed trab.
Hi Montalb,What an ordeal! What a year for you. I am very concerned that I may be a fast scarring person as well since the bleb closed up by the 8th month. I remember looking at the bleb then and though it's gone...couldn't make out the little bumb. I'm really not keen on doing it all again and will ask my doctor about a tube. Is 20 a good pressure for you? I just feel rather stuck because I know the trabeculectomy is the only operation that gets pressures low enough for some people and I need low teens.
Iāve just learnt that 20 is too high for me and Iām trying monoprost. I canāt take the other drops because of side effects and my consultant said it might mean another tube. Iām now on tenterhooks waiting for my next appointment in March.
If you are fast scarring then a tube is better. The operations are something you have to get through in my opinion, I donāt see another way.
For people who scar itās very important to take the steroids religiously. I hope everything goes well for you.
Well hopefully adding the monoprost will get the pressure lower and that that will be it for you! Still haven't haven come across anyone doing a second trabeculectomy along side a failed one. doesn't doesnseem tk be the best option. Best of luck in March!
Hi Montalb, I have just seen your post from several months ago, in which you mention your Paul tube. How are you getting on after having it inserted? I had one done almost three weeks ago and have been trying to find anyone else who has also had one. I have seen my consultant every week since the op and he prescribed steroid drops (Predforte) every two hours, for at least two months! I am also using Cosopt twice daily. I was told to use the antibiotic eye drops four times a day, but at my last visit, he said I could now stop using them. My days seem to be taken up with all these drops, but if it saves my sight it will be worth it. I am still having to use a cocktail of drops in my unoperated eye! I did post another article, but donāt think Iāve had any replies, only one ālikeā, so rather disappointed as I was hoping to hear from others with the same experience. Incidentally, are you a fan of āMontalbanoā the TV series? Regards, Gill
You guessed correctly, I like Montalbano!
I am now a year into my Paul tube. I believe the Paul tube has a narrower tube diameter than the Baerveldt, and I might be getting a Baerveldt next. My Paul tube is still working but it is not doing enough. I wasn't on as many steroid drops as you after the op and maybe that has meant that my Paul tube is scarring slowly. I was given glaucoma drops this January and more drops since, but I can't tolerate them long term. I have also just had cyclodiode laser that should reduce the amount of aqueos produced in my eye, but I don't think it has done the trick. I have another appointment next week.
The Paul tube is doing what it is supposed to, but I have a big problem with fast healing, as well as drop intolerances. It makes everything very complicated.
I wish you luck with your healing and glaucoma journey.
Many thanks for your reply. It is still very early days, three weeks tomorrow (Sunday) since my Paul tube was inserted, so fingers crossed it will be a success!
I hope it goes well
I had a trab on my left eye about this time last year. It failed after only about 10 days - the pressure hit 56! In the following week both sutures were removed, but pressure was still too high so I had a needling and more Mitomycin C applied. The pressure then fell as low as 4 in the few days after, but it's now settled at around 13 on an average day. (I bought an iCare tonometer so that I can monitor it myself).
Wow that's excellent you are in a good position now! I wish I had had needling ..but the cataract in the eye needed to be dealt with beforhand but now that I got the lens replaced I guess doing a whole new trab is a better option. I don't know....,
Dear Stephanie, Sorry to hear about all that you have gone through. It is so difficult to know what the best procedure is to follow.
Last week I wrote about my impending revision of my trabeculectomy that was done five years ago, in my left eye. I had a xen/stent put in even earlier, that didn't work, and this will be removed at the same time. Incidentally, m pressure in the left eye has dropped to 3/4.
I am writing as so many of us are in the same predicament and trying to do our best under difficult circumstances. I will write after my op due to take place at the end of the month.
All good wishes and strength to my fellow sufferers.
Hi Julunder, Thanks for writing! It's true each of us are in unique situations with varies operations, complications and decisions to be made. Sounds like the revision of your trab will work. From what I understand it may be easier to tighten up a bleb rather than loosen it up and get rid of scar tissue. Good luck with your op at the end of the month and let us know how it went!
Stephanie, Many thanks for the positive reply to my note and for the good wishes. I will get in touch after my op, hopefully with good news. All good wishes to you and anyone else going through what we are.
Hello Stephanie , I hope your operation is successful. I had trabeculectomy on each eye. One eye responded very well and no problem (2nd trabeculectomy) but other eye gave the problem (first trabeculectomy) . The usual problem of scarring like others mentioned above. It needed needling but did not work and now had tube insertion about a month ago hopefully it will work. Wait and see.
Hi balacakkhu!
What kind of tube did you get? I have my next consultation June 3. I really do not want to do another brand new trabeculectomy in the same eye...the first one was such an ordeal and so disappointing it failed completely due to scarring. I am on 3 different drop 2 times a day and the pressure is pretty good between 14-16. So that alone may be enough. In the beginning I had terrible intolerance to the drops that's why the trab was done in the first place, but I'm Ihoping it's it not necessary or that I could try a tube. So with time let me know how your new tube will work for you! Have a nice weekend!
Hello Stephanie, I am sorry for my late reply. My tube is Baervldt tube with Mitomycin and Tutoplast. I am still attending regular review. According to the consultant it may take about 6 months to know the proper result. The scarring was the problem in one of my last trabeculectomy.
Thanks Balacakkhu,I will look into it. Definitely don't want another trabeculetomy!
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