Cataract and Glaucoma

[MaryRoe]

I saw an eye doc at Baylor the other day as I suspected a cataract.  I chose this group because I felt they are experienced in cataract surgery.  He said the left eye has a grey like paint right over the left cornea and the right eye has it to the side so therefore he has suggested removing the left one only at this time.  I have not scheduled this yet as the glaucoma numbers were 25 (R) and 22 in the left. he said it day surgery with a local anesethics.

Question?  If glaucoma numbers do not go down...can one still have cataract surgery without making glaucoma worse?  Also, is there always some complications with cataract surgery.  Reading here, I am very concerend about post complications. Is this usually because a patient had very poor eyes to begin with or is it because of the surgeon's qualifications. I am concerend.  My vision is very poor now but I will forgo all surgery if complcations making my eyesight worse will end up homebound.
Thanks for your help, Doctor.

[Forum-OD-MP]

*USUALLY* (certainly not all the time, but in my experience MOST of the time) having cataract surgery actually IMPROVES glaucoma (makes the intraocular pressures go DOWN).  so that would be another reason besides improved vision for considering cataract extraction.

in general cataract extraction is a very safe procedure.  actually it is one of the safest if not THE safest surgery in the history of mankind.  it is also THE most common surgery in the history of mankind.  way more people have had cataract extraction than say knee surgery...its not even CLOSE.

we have a disproportionate number of patients here who complain about problems, b/c this is where they come to post when they are frustrated and looking for answers.  the VAST MAJORITY of patients who have cataract extraction have NO complications at all.  those people of course are not posting here.

when cataract extraction goes wrong, it is usually NOT the surgeon's fault.  it is usually just bad luck.  since cataract extraction is so common, every eye surgeon knows how to do it and
has had plenty of experience and the technology is there to make it very easy.  

i am not telling you to have cataract extraction surgery.  i am only telling you that it may improve your glaucoma and your sight, and that in general the risks are fairly LOW, even for a glaucoma patient.

[MaryRoe]

Thank You, doctor and Medhelp.  I learned something today.  I have been down in learning that now I have both Cataracts and possibly glaucoma )-:  It is *&%^%^* to get old.  You mentioned knee surgery...this is on my list too but first I need to get off Plavix for the MI and heart stents.  Eye doctor said I do not need to be off the Plavix for eye surgery. That same eye was operated on about 6 years back for SLK.  My list is long but I am hanging in there and I do laugh more than I cry.  Thanks again.  I see the eye doc again in 2 weeks.
When I have the surgery, I will post positives....

[eyecu]

You should be fine. They can remove the catract and perform a trabeculectomy at the same time to reduce the pressure in your eye and even possibly get you off the meds for glaucoma. Your pressures are not too high and you might end up with a cure for both problems in one prodecure.

[MaryRoe]

Thank You.  I hope to do just fine.  Yes, wouldn;t it be wonderful that right after surgery i will be able to turn on lights without covering my eyes and thread a needle again and drive the car at night and read fine print and be able to watch some good TV programs without the haze.  I think I would of died and went to Heaven.  (-:   Thanks for your support.

[eyecu]

Baylor where? Houston or Dallas? No sense in being miserable.My mother had surgery and she had the same pressures as you do which some surgeons say are border line glaucoma. You also have to have visual fields, measure corneal thickness which can actually lower those numbers etc.The bottom line is there is always a risk with surgery but the upsides out weigh those risks if you look at the percentages and you should have an improved quality of life. A mutlifocal lens can help you in your activites as well. You have some exciting options today.

[ClearAsMud]

Hi,

My 83yr old mother has both cataracts and angle closure glaucoma. The fluid pressure in her eyes ranges between 24 and 28. Her long standing specialist recently suggested a laser operation to relieve the glaucoma.

She sought a second opinion and the recommendation was to do the cataracts only, as probably the pressure will lower itself afterwards.

Then she went to see a thirds specialist who suggested that she should have surgery for both the cataracts and glaucoma together, because in his opinion, the fluid pressure raises after a cataracts operation and also there is  a high risk that debris can block the drainage channels. Both felt that in her case the proposed laser surgery would be a waste of money and time.

She is now completely at a loss.

Any suggestions most welcome and many thanks.

Best Regards
ClearAsMud

[ClearAsMud]

Hi,

Iapologize, but should have added that she has angle closure glaucoma and is not on any kind of drops becuase she is allergic to most medications

Best Regards
ClearAsMud

[eyecu]

Clear as mud. If your grandmother has cataracts, she might as sell have them removed because she is not going to get better. They just get worse. As we age, I can't really say that anythhing is going to get better. They can remove the cataract and do a trabeculectomy at the same time if they feel she needs it which will take care of both problems. That is the way I would go. It is a simple procedure with a small extra step of the trab to relieve the pressure in the eye. No need for the laser is she is going to have to have catract surgery anyway. Go to a cataract surgeon who is glaucoa trained for the answer.