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Medical Forum / Diseases and Disorders / Glaucoma / August 2004I had an iridectomy...
performed by a glaucoma specialist in So. Calif. this morning. I was diagnosed last week with angle closure glaucoma which, per the doc, is quite uncommon, especially for a myopic (that's me). One hour post-op, he took IOP readings. The left eye which was 23 before the surgery dropped to 20; right eye up to 23 was 20 just before surgery. he stated that these numbers are meaningless now and can be caused by "debris". he remarked that next week's readings will be more telling both undilated and dilated (especially). Anyone been through this who knows if this sounds about right post-op? Stu > performed by a glaucoma specialist in So. Calif. this morning. I was > diagnosed last week with angle closure glaucoma which, per the doc, is quite [quoted text clipped - 9 lines] > > Stu I waited several days to post here to see if any fellow narrow angle patients would respond. As no one has, I'll throw my two cents in. Of course, I've never been through this on the receiving end, but I have performed more than my share or laser iridotomies. I have to say, I've never heard of a surgeon performing an iridotomy on both eyes at once. Even though the risk of such a procedure is very low, performing bilateral surgery is usually frowned upon by insurance companies. I usually wait a week or two between eyes. Nevertheless, in answer to your question, your surgeon is correct...debris and pigment released from the iris may temporarily raise IOP after a P.I. by partially "clogging the drain." The initial postop IOP is therefore not as important as the one week postop IOP. I'm sure you'll do fine...most do. Good luck, Rick Cohn, MD Glaucoma Specialist Winter Park, FL Dr. Cohn- Thanks for your post. I believe he lasered both eyes as he saw the angle closure upon exam in both eyes AND when dilated both eyes IOP go up measurably, albeit the left more than the right. I am a pessimist and suspect the surgery failed based on the one hour post-op IOP readings noted in my first message herein. I have a question for you- Since the surgery, I have noticed while viewing a TV or monitor in a dim or dark room that a squint of my upper eye lid or actual blink causes a glare line bilaterally in my field of vision, almost like a floater, move in tandem motion with the eyelid. If I hold up the upper eyelid and move my eye, I do not see this glare line type floater. Similarly, if I pull the upper eyelid away from the eye and blink a few times, those first few blinks are absent the glare line type floater. I suspect that the upper eyelid is moving something on my eye as I blink or squint. This is disconcerting but a small 'price to pay', if the surgery proves successful. I should mention that I am using prednisilone eye drops 4X daily until I see the ophthalmologist on Wednesday. Any idea what this glare floater might be and whether it is a permanent effect? > > performed by a glaucoma specialist in So. Calif. this morning. I was > > diagnosed last week with angle closure glaucoma which, per the doc, is quite [quoted text clipped - 26 lines] > Glaucoma Specialist > Winter Park, FL > Dr. Cohn- > [quoted text clipped - 17 lines] > ophthalmologist on Wednesday. Any idea what this glare floater might be and > whether it is a permanent effect? First of all, as I mentioned in my last post, you can't tell anything based on your IOP one hour after the procedure. I don't even check my patients' IOP until the next day in the office because that number is so irrelevant. It could be higher, lower, or the same...don't make any judgements. Second of all, the glare you are experiencing is quite common. It almost certainly is from light entering the iridotomy. If the iridotomy is large enough, light will enter, almost as if another pupil existed in the same eye. I've had 2 or 3 patients complain about this over the years whenever I made their P.I. quite large. I now try to avoid that by placing the P.I. far out in the periphery superiorly (at the very upper edge of the iris), so that it resides beneath the upper eyelid. If that is indeed the case, nothing can really be done about it...I should mention however, that it might improve with time (sometimes the P.I. gets a little smaller with time as pigmented cells or inflammatory cells fill it in a little). Drooping of the lid with age, or squinting a little may cause the upper lid to cover the P.I. and get rid of the glare. Those who complained about it to me a few years ago never mention it anymore (implying that it got better with time or they knew there was nothing I could do about it). Lastly, Pred Forte 4 times a day is appropriate after a P.I. Good luck to you. --Rick Cohn, MD Glaucoma Specialist Winter Park, FL I just had a Laser Iridotomy today. The nurse at the hospital said I am the best patient for them today! <smile> The other pateints we talked to before I had mine done said there is pain.....but I never felt pain!! The surgery is not bad -- and it's painless! All I have to do is look at a red light, and I saw flashing lights (like a camera) with colors (I saw red)....and then my surgery is over! I had a little bit of pain afterwards but it wasn't bad -- then I had my pressure checked. It went up again a little bit...so I was put on some drops including the medication I usually use. Then they checked my pressure again after waiting for 30 minutes -- and it went down to 18! Good job!! I have to take this new eyedrop medication to work to help reduce the inflammation so I will use it during my lunch hour....it won't be a problem for me when I am trying to work. I was told I will have my other eye done later -- in January....so I will let you know ahead of time. :) I already took the inflammation eyedrop earlier and boy, does it burn! I was told that it is going in the "open wound" to heal it up so that's why it felt like that. :) Just want to let you know what I experienced my surgery today. :) Nancy Nancy- Good luck!...I had a poor result. In fact my surgery was bilateral and the IOP's went from 18 (R) and 22 (L) to 23 and 24, respectively, one week later post-op. The doc sees it as a failure and is pitching a bilateral iridoplasty. I am seeking at least a second opinion tomorrow morning. I am back on Pilocarpine, which exacerbates a glare line created when I squint or blink the upper eyelid. This is a wonderful adverse effect of the surgery!. Stu > I just had a Laser Iridotomy today. The nurse at the hospital said I > am the best patient for them today! <smile> The other pateints we [quoted text clipped - 18 lines] > > Nancy Has anyone ever had a bilateral iridectomy for preventative reasons for threatened closed-angle glaucoma? I am scheduled for this surgery at the end of August and don't feel very confident about the procedure. My eye specialist has made me feel like a "walking time bomb" though I have to date never experienced one of these acute attacks (I'm 62). Any comments out there? Barbara Canada > Nancy- > [quoted text clipped - 29 lines] > > > > Nancy |
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