Trabeculectomy for ‘stronger’ eye

[YoungontheOutside]

Hi there,

My consultant wants me to have a trabeculectomy on my good eye. I haven’t lost any peripheral vision there yet but the pressure has crept too high.

I had a trab on the weaker eye three years ago but my acuity was affected as a result and my optician was unable to correct it with glasses. I think the operation came very late in the day as I had already lost some peripheral vision and my pressure had too high for sometime before they finally operated.

I think for my good eye they are trying do the op more timeously so I’m hoping for a better outcome. But I’m still quite worried because if I lose vision in the good eye, then that will really impact mine and my family’s life going forward.

Has anyone else been in a similar position? Did you lose vision as a result of having a trabeculectomy or was your vision as good afterwards? And were you able to keep on driving? I really need to hear that I might get a positive outcome!

For the record, they tried yag laser surgery twice before the first trab but it didn’t improve things.

[Cyclops037272]

I had same symptoms as you. Had it done in good eye , I am sorry I had it done. Periferal us now bad. Don't do it .. !!

[VerdiG]

I am in same situation. Had trab on my right eye 4 years ago. It didn’t affect my vision but I think I I have lost a bit more vision in that eye since then. So not convinced it works better than the drops. I really don’t want to take the risk of a trab in my left eye either. Not convinced that eye pressures are the only factor and different consultants have different opinions.

[Sorshup]

Very difficult. I have a similar history and currently await resoution of a glued-up eye that leaked following second trab revison (which also has affected sight).

But for you the IOP has to come down; Interrogate your consultant about tube surgery - what are the risks of that cf trab?

[Cornwalleyes]

same as you, had first eye done and it stayed the same. Second eye done a year later although it wasn’t deteriorating and was being managed by drops. Consultant advised the drops don’t work forever. Second eye fine too, no loss of what vision I had in either eye. Seems everyone really is different looking at your other responses.

[Bess21]

Have you read about canaloplasty it can be alternative to trab

[VikingBecky]

Hi 🙂

I'm sorry you're going through this, it's a stressful situation when the good eye starts playing up.

I was in a similar situation tube surgery wise a couple of years ago. I'd had a tube implanted in my left eye in 2015, and my cornea has decompensated so vision is very poor (counting fingers). Then the IOP in my right eye crept up out of control in 2023 and they wanted to do a tube surgery in that one to bring things back under control. Because of what had happened with the tube in my left I was petrified. In the end we went ahead, as nothing else was working, and so far so good.

From my experience there are a few things I would do here - apologies if you've already got this covered:

- Try different drops. Before surgery I've always been given various different drops to add / existing drops taken away to see what that does to pressures. I'm sure that's already been done.

- Try Acetazolamide (Diamox) tablets. If you can face it. I absolutely hate these, and when things with my right eye were kicking off I was on them for over 3 months with all the side effects and zero impact on IOP. BUT in theory they should work as intended and bring your pressure down.

- Ask for alternatives to a trab, as others have suggested. Obviously there are risks to any surgery, and with the tube shunt there are different types they can implant which can have different outcomes too.

- Ask for a second opinion or referral. I didn't do this, but I had a different doctor in 2023 to the one who implanted the tube in 2015. She was considerably less arrogant, and very quickly referred me to Moorfields - which is where I had the tube implant done in 2023 and where I'm now formally registered as a patient. I don't know your situation in this regard, and it's tricky when different surgeons have different opinions to know which option is the "right" one, but asking for a second opinion from someone is worth doing.

Driving wise: the tube implant in the right eye was successful and when corrected my vision is good enough to drive. The vision in the left eye is shot. I had to take a DVLA vision test at Specsavers (which also had me petrified - losing my license is a significant fear), and combined I have enough visual acuity / visual field that I can still drive. I'm on a 3-year medical review licence, so once the 3 years are up it'll be back to Specsavers for another test.

All the best to you 🙂

Becky

[YoungontheOutside]

thank you to everyone who has replied. I had to take Acetazolomide and my feeling at the time was that I would crawl over cold not to have to take that ever again! I will try and bring my consultant round to looking at other eyedrops before having another trab.

He was so pleased with the ‘success’ of the first trab because the pressure has stayed down in that eye. The fact that I then got uncorrectable distance vision and diplopia in that eye was neither here nor there. I think it was too late for anything else but a trab in that eye by the time they offered it but my pressure isn’t nearly as high my good eye at the moment so I’m hoping that drops might work for a few years longer.

[Eahldt]

I’d just like to confirm what other people have said having been in exactly the same position. The trabeculectomy done on my right eye was necessary because of sight loss. I was shocked to be told, some years later, that I should have one on my left eye. I was so shocked I didn’t ask questions or get a second opinion. The recovery was nowhere as straightforward as on my right eye and I think my distance vision is slightly worse. When I was sent an eye clinic appointment recently I was so concerned I might be talked into further surgery because the trab in my right eye no longer works that I asked my husband to go with me to back me up if necessary. Fortunately his presence was redundant as I was told my sight is currently stable and to continue with drops. I think you are right to be cautious.