Are there any advanced glaucoma treatment options for me?

Question

Hello doctor,

My mom is a glaucoma patient for the last 10 years. She has been on medications like eye drops, including Azopt, Ganfort, Alphagan, Vigamox, and prior to them, Cosopt (which did not suit her). She has gone through retina eye laser and also has been injected in both her eyes almost 22 times for retinal leakage as well, and has also gone through cataract eye surgery 16 years ago.

At the moment, her eye pressure remains between 21 and 24. The doctor says implants are necessary as she can see very little now. Given her eye condition is sensitive, a doctor has suggested that it is best to operate on her with an Ahmed valve implant; however, it has its own risks. I wanted to know if it is better to try the latest option, called MIGS (minimally invasive glaucoma surgery), like Xen Gel Stent and InnFocus Microshunt, as it has nearly no complications. I want to get an opinion about this before thinking about the Ahmed valve.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I am very sorry to hear about your mother's eyes. I suspect that she must have undergone the retina laser and the injections for a condition called diabetic retinopathy. I feel that most likely it is a complication of diabetic retinopathy that might have caused high pressure in her eyes. Xen gel stent is currently FDA approved for refractory glaucoma not caused by diabetic neovascularization, and Inn focus micro shunt is currently being tested for long-term side effects and usefulness in such situations.

I must be clear in letting you know that neovascular glaucoma is a very difficult disease to treat, and the treatment may not be straightforward and may require multiple procedures and reviews with the treating doctor, yet the most often agreed upon surgery, across most hospitals in the world, is currently the Ahmed glaucoma valve, along with, of course the laser and injections. In case you need further clarification, or if your mother is not a diabetic, please send a scanned copy of all her doctors' records and prescriptions. I will do my best to help you understand the situation.

I hope this helps.

Please revert in case of further queries.

Thank you.