Our Summary

This study looks at patients with glaucoma, a type of eye disease, who had surgery without taking any glaucoma medication beforehand. The researchers reviewed medical records from a hospital in Japan and found that out of 1,417 surgeries, about 6.4% (or 90 surgeries) were performed without the use of medication.

The most common type of glaucoma in these cases was primary angle-closure disease (PACD), where the fluid inside the eye cannot drain properly leading to increased pressure. The second and third most common types were exfoliation glaucoma (EXG) and primary open-angle glaucoma (POAG), respectively.

The main reasons for not using medication before surgery were the need to relieve angle closure (a condition associated with PACD), the diagnosis of glaucoma during a routine eye examination, poor adherence to medication, dementia, multiple medication allergies, and sudden increase in eye pressure not related to PACD.

The most common surgical procedures carried out were cataract extraction either alone or in combination with other procedures. The researchers conclude that in real-world scenarios, about 6.4% of glaucoma surgeries are performed without medication and the reasons for this vary.

FAQs

  1. What is the most common type of glaucoma found in patients who had surgery without taking any medication beforehand?
  2. What are the main reasons for not using medication before glaucoma surgery?
  3. What is the most common surgical procedure carried out on patients with glaucoma who don’t take medication beforehand?

Doctor’s Tip

A helpful tip that a doctor might give a patient about glaucoma surgery is to make sure to follow the post-operative care instructions carefully, including using prescribed eye drops as directed and attending follow-up appointments. It is important to monitor for any changes in vision or symptoms such as increased pain or redness, as these could indicate complications that need to be addressed promptly. Additionally, maintaining a healthy lifestyle and managing any underlying health conditions can help improve the success of the surgery and long-term outcomes for managing glaucoma.

Suitable For

Overall, patients who are typically recommended glaucoma surgery are those who have not responded well to medication or have severe symptoms that cannot be managed with medication alone. In this study, the patients who underwent surgery without medication had various reasons for not using medication, such as angle closure, poor adherence, or medication allergies.

It is important for healthcare providers to carefully assess each individual case and determine the most appropriate treatment plan for the patient. Surgery may be recommended for patients with advanced glaucoma, those who are non-compliant with medication, or those who experience sudden increases in eye pressure. It is crucial for patients to work closely with their healthcare team to ensure they receive the best possible treatment for their condition.

Timeline

Before glaucoma surgery, a patient may experience symptoms such as blurred vision, eye pain, redness, and halos around lights. They may also undergo various tests to diagnose the type and severity of their glaucoma, such as visual field tests and measuring intraocular pressure.

After glaucoma surgery, a patient may experience some discomfort, blurred vision, and sensitivity to light. They will be prescribed eye drops and medications to prevent infection and reduce inflammation. Follow-up appointments with their ophthalmologist will be scheduled to monitor their progress and ensure the surgery was successful in lowering their intraocular pressure and preserving their vision.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What type of glaucoma do I have and why do I need surgery?
  2. What are the potential risks and benefits of the surgery?
  3. What are the alternative treatment options to surgery?
  4. Will I need to continue taking medication after the surgery?
  5. What is the success rate of the surgery for my specific type of glaucoma?
  6. What is the recovery process like and how long will it take?
  7. Are there any lifestyle changes I should make after the surgery?
  8. How often will I need to follow up with you after the surgery?
  9. What should I do if I experience any complications after the surgery?
  10. Are there any specific instructions I should follow before the surgery, such as stopping certain medications or fasting?

Reference

Authors: Sugihara K, Fukuda H, Omura T, Tanito M. Journal: BMC Ophthalmol. 2022 Mar 30;22(1):145. doi: 10.1186/s12886-022-02369-z. PMID: 35354394