My eye pressure is fluctuating between 22 to 28. Do I need implant surgery?

Q. My eye pressure is fluctuating between 22 to 28. Do I need implant surgery?

Answered by
Dr. Rahul Vaswani
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 28, 2018 and last reviewed on: Jul 12, 2023

Hello doctor,

I am a female of 62 years age. I was operated for cataract five months back for both the eyes. As my cataract was only 20 %, but eye pressure was 22. My OCT was done, which showed no damage to nerves. My perimeter too is clear. No family history of glaucoma. I was put on various drops which could not bring eye pressure in the expected range for the doctor (fluctuation between 22 to 28). She suggested implant surgery to make eye pressure normal. Another doctor stopped eye drops saying I do not have glaucoma. And, do not need eye drops too. I am confused.



Welcome to

It is a practice that if perimetry is normal, one waits to start any antiglaucoma medication. The protocol is to graph your IOP (intraocular pressure) for 24 hours or IOP at different times of day repeatedly for a week, then one can decide if you have glaucoma or if you are just a case of ocular hypertension. Let me tell you there is no need of any implant and these many medications should not be started now. Chart your IOP, also a gonioscopy. Then, one can decide if one has to start medication.

Thank you doctor,

Pachymetry shows moderately thin cornea and gonioscopy shows occludable angles. Adds 1 in IOP in the left eye and 3 in IOP in the right eye. What further steps do you suggest?



Welcome back to

Even after IOP correction, it is 23 and 25 and perimetry is normal. So, as I said, go for 24 hour IOP charting. Also, do a chamber volume in which parameter can easily be measured and if 110 or below, you can have YAG laser iridectomy as you have narrow angles. And, after that, if they are willing to start any drug, it should be a single drug, preferably a Latanoprost. See how effective it is and then add any other drug only if needed.

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