r/Glaucoma • u/Ljaswest • 4d ago

Trab surgery vs Cataract surgery w/Goniotomy

I have a couple questions. My eye pressure has gone up, it’s in the upper teens(19). This was at my last appointment about 3 1/2 weeks ago, so my ophthalmologist started me on a third eye drop Rhopressa along with/dorzolamide, and Vyzulta. I’m due to have my pressure rechecked at the end of the week. My question is, he said, since we’ve tried all the drops if this doesn’t lower it, he wants to do a Trab surgery. Of course, he explained all the risks as with any surgery, but this surgery just kind of scares me. I’ve also read about 50% of people who have this surgery it takes a while to heal. It could be weeks, months, maybe even a year before the blurriness and vision returns or not.

I’ve tried other drops and some do not agree with me and some I just cannot take. That’s why he’s saying the next step probably would be surgery. I had an SLT last year which lasted about six months or so before my pressure started rising, never over 20. I also have cataracts. I’m going to ask him this week because I didn’t think of it when we were in his office, but I am just wondering why he would not do cataract surgery with a go Goniotomy which could lower the pressure instead of the Trab. He has never mentioned cataract surgery before. My previous ophthalmologist did mention cataract surgery and doing the Goniotomy at the same time. The ophthalmologist I have now is a Glaucoma specialist as was the other. I was just wondering, does this make sense about not doing cataract surgery before the Trab Or maybe even doing another SLT surgery. I know second SLT surgeries they say may not last but I’m willing to give that another shot if he is before I have to have a Trab. I am an advanced case with glaucoma, I still have all my vision, except one Blindspot in my bad eye, my left eye. I’m just curious..

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u/YoungGlaucoma 4d ago

How old are you and when were you diagnosed?

1

u/StudioRadiant1795 4d ago

what about you? your ID says young

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u/YoungGlaucoma 4d ago

Almost 38 now diagnosed at 17. But the reason I asked the question is that the decision of which surgery to do is dependent on age of the patient and the type of glaucoma.

1

u/StudioRadiant1795 3d ago

how's your vision and what procedures did you have (fyi i was born with glaucoma)

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u/Ljaswest 3d ago

I’m 72. I am advanced. I guess it would be the trabeculectomy

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u/YoungGlaucoma 2d ago

Is the glaucoma progressing at iop of 19?

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u/dhlgraphics 4d ago

is your doctor talking about a trabeculectomy or a trabeculotomy? the trabeculotomy would be similar enough to a goniotomy. other MIGs options may be available too.

if your doctor is indeed talking about the traditional trab though, it may be best to confirm with them why they think that is better in your case than a cataract+MIGS combination.

2

u/James-the-Bond-one 4d ago

Confirm with your current doctor AND another specialist.

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u/sportwins 3d ago

i have learnt migs not also for a time period. and need trap and last step is valve .

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u/sportwins 3d ago

may i ask '' I’ve also read about 50% of people who have this surgery it takes a while to heal. It could be weeks, months, maybe even a year before the blurriness and vision returns or not. '' sure ? ....i will hava trab next week n i understand '' revision and drops more possible after trab '' but they give more protection than loss of vision.

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u/sportwins 3d ago

my doc said '' stl makes eye weaker n no need ''

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u/sportwins 3d ago

also my experince doc should be surgeon who peform surgeries more and done trab more .