Advice please. Has anyone had a cataract and glaucoma op done at the same time? (1 Viewer)

[StephandJohn]

My ophthalmologist says they can do that but there's a risk of 'washout phenomena'.
He wasn't very good at explaining what that is so I'm going to see if I can get a better explanation from an optician but I think it means that the op might make the glaucoma worse.
Knowing the wealth of experience on here I thought someone might know.
Thanks.
Steph

 

[Nirvanauk]

wino might help.

 

[Branston]

My ophthalmologist says they can do that but there's a risk of 'washout phenomena'.
He wasn't very good at explaining what that is so I'm going to see if I can get a better explanation from an optician but I think it means that the op might make the glaucoma worse.
Knowing the wealth of experience on here I thought someone might know.
Thanks.
Steph

Mrs. B had both done on one eye ( awaiting date for second) her surgeon didn't mention washout phenomena so she can't tell you what it means but the op was a complete success! Can now see clearly what she ended up with, me!

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[gus-lopez]

but there's a risk of 'washout phenomena'.

yes I was going to suggest wino also

 

[cyberyacht]

OH had a 'bleb' op a couple of years back which required additional 'tweaking'. Eyesight still declining and now on even more eye drops. DVLA said no more driving last autumn. We're both well past our 'three score and ten' so how long should we expect to last before becoming an MOT fail.

 

[nicholsong]

I would never consider having two operations to one eye at the same time. I had cataract operations to both eyes a year or so ago but thankfully they were scheduled for 12 weeks apart in case of complications. I think that is the safe way.

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[StephandJohn]

I've been wondering about that but they've been doing the two together in America for quite a while and I can't see any problems. Also, despite lots of daily eye drops my glaucoma is getting worse so hopefully the glaucome op would help.However I'm going to see the chief surgeon before a decision is made so I'll hopefully get some sensible advice there

 

[Branston]

I've been wondering about that but they've been doing the two together in America for quite a while and I can't see any problems. Also, despite lots of daily eye drops my glaucoma is getting worse so hopefully the glaucome op would help.However I'm going to see the chief surgeon before a decision is made so I'll hopefully get some sensible advice there

I believe that it's a new technique that is being used now, as previously posted, Margaret is pleased with the outcome.

 

[HKF]

I've had both done, at separate times. I was under Mr Subramaniam at The Park Hospital in Nottingham. He said there was no way he would do refractive lens surgery until my Glaucoma was done, due to the possibility of a rise in pressures during the surgery. So, I first had the Glaucoma sorted on the NHS and then went back to Mr Subs for my new lenses. The laser for Glaucoma was painless and a total success. The surgery for refractive lenses was painless but the drops afterwards are a necessary pain the the bum. 100% well worth having both done but get your Glaucoma sorted first

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[HKF]

I've had both done, at separate times. I was under Mr Subramaniam at The Park Hospital in Nottingham. He said there was no way he would do refractive lens surgery until my Glaucoma was done, due to the possibility of a rise in pressures during the surgery. So, I first had the Glaucoma sorted on the NHS and then went back to Mr Subs for my new lenses. The laser for Glaucoma was painless and a total success. The surgery for refractive lenses was painless but the drops afterwards are a necessary pain the the bum. 100% well worth having both done but get your Glaucoma sorted first

Juast to add to this, the drops after the lens surgery are for 6 weeks only. My post may have made it sound like they were forever. I'm now completely drop-free Also, because of the way my eyes are, Mr Subs did my left eye for near sight and my right eye for distance. My brain had figured it out n a couple of days and now I can go from, say, reading a book to looking miles away with no interruption in vision. For the first couple of days it was a bit odd, as my brain gave me 'jumpy' switches from near to distance and back again. But, after a couple of days it was perfect

 

[The Wino]

Everyone is different and there are lots of different operations for glaucoma some of the more recent ones are minimally invasive glaucoma surgery (MIGS) often combined with cataract surgery but they are generally only useful where a relatively small reduction in IOP is necessary and quite often not available on the NHS.
Conventional glaucoma surgery is a trabeculectomy which forms a different way for fluid to flow from the eye to a bleb under the conjunctiva . It usually works well but there can be complications if the reduction in pressure is too much or not enough and the eye tends to try and heal the drainage so steroid drops are usually needed for some time after to try and control healing and sometimes repeated procedures to keep the pressure down. A side effect of trabeculectomy is that people generally develop cataracts more quickly so if there's any significant cataract people are generally offered cataract surgery first ( it often lowers pressure a little anyway as the implant takes up less room and opens the drainage a little) and glaucoma surgery once healed.
But every case is individual if the glaucoma is advanced delaying glaucoma surgery will mean some further irreversible loss of sight due to glaucoma .
Wipeout is where theres a sudden permanent loss of sight at the time of surgery.
I think you really need to trust your surgeon or find another who you do trust and ask what they would advise. I wouldn't ask a load of motorhome owners who happen to have glaucoma or cataracts as they will all have different outcomes for exactly the same surgery!
I wouldn't get hung up at all on the refractive outcome ( what glasses you need afterwards) if you have advanced enough glaucoma to be advised to have surgery to reduce the pressure it could be that the visual field is compromised to a point where one eye distance and the other near isn't a great idea again I would ask the surgeons advice ( a boring answer but it's not like choosing a different motorhome after all it's reckoned to take most people three goes to get that right!!)
Feel free to ask any questions pm me if you like I'm retired now for two years it could be some of the advice is out of date but the basics don't change).

 

[The Wino]

Juast to add to this, the drops after the lens surgery are for 6 weeks only. My post may have made it sound like they were forever. I'm now completely drop-free Also, because of the way my eyes are, Mr Subs did my left eye for near sight and my right eye for distance. My brain had figured it out n a couple of days and now I can go from, say, reading a book to looking miles away with no interruption in vision. For the first couple of days it was a bit odd, as my brain gave me 'jumpy' switches from near to distance and back again. But, after a couple of days it was perfect

He's a surgeon who specialises particularly in refractive and laser surgery. If I had advanced glaucoma I'd probably choose a surgeon whose NHS position was a lead in glaucoma!

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[nicholsong]

Juast to add to this, the drops after the lens surgery are for 6 weeks only. My post may have made it sound like they were forever. I'm now completely drop-free Also, because of the way my eyes are, Mr Subs did my left eye for near sight and my right eye for distance. My brain had figured it out n a couple of days and now I can go from, say, reading a book to looking miles away with no interruption in vision. For the first couple of days it was a bit odd, as my brain gave me 'jumpy' switches from near to distance and back again. But, after a couple of days it was perfect

I had no drops after either of my cataract operations. What is the difference?

 

[The Wino]

I had no drops after either of my cataract operations. What is the difference?

Quite often people have a combined therapy of antibiotic drops to reduce the risk of infection and seroids to reduce any inflammation. As always opinions will vary on whether it's a good idea or not. It's the same with the anaesthetic for the operation some use drops only others a local injection others particularly if the patient is jittery or requests it a general anaesthetic.

 

[HKF]

He's a surgeon who specialises particularly in refractive and laser surgery. If I had advanced glaucoma I'd probably choose a surgeon whose NHS position was a lead in glaucoma!

I did. Mr Subs did my refractive surgery privately after my Glaucoma was treated on the NHS by a different surgeon. I didn't mean to imply that Mr Subs had done both. I'm sorry if it came across that way.

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[HKF]

I had no drops after either of my cataract operations. What is the difference?

From memory, one was a painkiller and the other was to prevent infection. I started at 6 times a day, reducing gradually over 6 weeks to nothing.

 

[The Wino]

I did. Mr Subs did my refractive surgery privately after my Glaucoma was treated on the NHS by a different surgeon. I didn't mean to imply that Mr Subs had done both. I'm sorry if it came across that way.

Could be a smart move a lot of refractive surgeon's do a lot of cataract surgery and have very good technique. It's particularly important after cataract surgery the reason cataract surgery is done first if there's any sign of cataract at the time of glaucoma surgery is that cataract surgery alone in some people reduces pressure and cataract surgery after successful glaucoma surgery can make the glaucoma surgery fail with the healing process from the cataract surgery.

 

[The Wino]

From memory, one was a painkiller and the other was to prevent infection. I started at 6 times a day, reducing gradually over 6 weeks to nothing.

One would be a steroid and the other an antibiotic. 6 weeks is a bit longer than normal probably because of the previous glaucoma surgery

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[HKF]

One would be a steroid and the other an antibiotic. 6 weeks is a bit longer than normal probably because of the previous glaucoma surgery

Thanks for the correction, although one wouldn't have been a steroid as I'm a steroid responder. In fact, it was a steroid inhaler that I was put on in the US that caused my Glaucoma.

 

[The Wino]

Thanks for the correction, although one wouldn't have been a steroid as I'm a steroid responder. In fact, it was a steroid inhaler that I was put on in the US that caused my Glaucoma.

If it was just a steroid response the pressure would normally reduce once the steroids stopped although any damage caused would remain. Maybe you had a non steroidal anti inflammatory after the cataract surgery or a steroid less likely to cause a response.

 

[nicholsong]

I had no drops after either of my cataract operations. What is the difference?

I am told that my memory is wrong and that I did have drops.

Labotomy next? Does that need drops?

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[HKF]

If it was just a steroid response the pressure would normally reduce once the steroids stopped although any damage caused would remain. Maybe you had a non steroidal anti inflammatory after the cataract surgery or a steroid less likely to cause a response.

Once I was no longer on the inhaler, they couldn't get the pressures down. My pressures remained at around 34 in my left eye and 30 in my right eye. My left optical nerve suffered the most damage and is quite concave now. It's always been my weakest eye but I lost some peripheral vision in my upper right area. Fortunately, that's compensated by my right eye. I've been very lucky, in that I now need no drops at all and only need glasses for computer work or reading. Plus my pressures are now around 10 in each eye I'm immensley grateful to the NHS for the work on my Glaucoma and to Mr Subs for the refractive surgery.

 

[The Wino]

Once I was no longer on the inhaler, they couldn't get the pressures down. My pressures remained at around 34 in my left eye and 30 in my right eye. My left optical nerve suffered the most damage and is quite concave now. It's always been my weakest eye but I lost some peripheral vision in my upper right area. Fortunately, that's compensated by my right eye. I've been very lucky, in that I now need no drops at all and only need glasses for computer work or reading. Plus my pressures are now around 10 in each eye I'm immensley grateful to the NHS for the work on my Glaucoma and to Mr Subs for the refractive surgery.

The big advantage of pressure control by an op is that you get 24 h control .

 

[cyberyacht]

Every licence renewal is a bit of a tense time as I wonder if DVLA are going to pull the plug on me. My next visit with my consultant is just after our six week jaunt to Andalusia so at least I'll hopefully be able to argue that I've just driven x miles across Europe in a motorhome without issue.

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[StephandJohn]

Thanks Wino and everyone. Very useful info and something to ask the surgeon about.