What is the treatment for an open-angle glaucoma?

Question

Hello doctor,

I had bilateral laser peripheral iridotomies performed a few years ago as a preventative measure because I was at risk of developing closed angle glaucoma. I was recently diagnosed with open angle glaucoma which is thought to be in an early stage. I am being treated with Xalatan eye drops. Since you have not examined my eyes, I appreciate that you may not be ale to offer a definitive opinion. However, generally speaking, can a person have Selective Laser Trabeculoplasty (SLT) for open angle glaucoma to alleviate intraocular pressure even though the person has already has laser iridotomies? I have another question. I understand that it is a common practice to have a follow-up medical appointment one or two days after glaucoma surgery. In your personal opinion, is it better to have the surgeon examine the eye to ascertain whether there are any complications or would a telephone consultation be good enough? Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Considering your age and vision status at present, you are likely to be at a considerable good status of glaucoma. 1. SLT can be a good option, to be free of drops usage. iridotomy has been done in a single sector of iris, slt has 3 more sectors to be used for it. so yes it is an option. but as u r on single eye drop, and if iop (intra ocular pressure) is controlled with it, i would suggest you to keep using it. 2. perimetry and oct rnfl tests to be done . vision with spectacles and a optic nerve examination also. do share me these reports here 3. surgery for glaucoma not advisable as it's manageable with less invasive techniques. 4 diabetes and lipids are associated comorbidities but not directly contributing to glaucoma. keeping them checked is advised. hope I m clear. will be helpful in future follow ups take care

Answer 2

hello sir. yes cataract surgery is advisable once the vision deteriorates further, and a telephonic consultation is fine on 2/3 day post op. u may go with it. corneal thickness is a bit higher, so corrected iop will b lower by 2 from these values so it comes under normal range, moreover latanoprost will lower it by 30% more so the target pressure will be achieved and the glaucoma progression slows down to a considerable extent. the optic nerve damage is less , it shall progress slowly. pls get 2 monthly iop checkups, and yearly perimetry and oct check ups . continue latanoprost along with lubricant eye drops frequently to prevent it's side effects. the efficacy reduces in a long run say 5 years , by then cataract will be operated and that will have a iop reducing effect on its own. so need not worry on it ur treatment plan is working on good. take care