Our Summary

This research paper is about how to manage eye pressure during cataract surgery. Cataracts and glaucoma often occur together, and as cataract surgery becomes safer and glaucoma treatment advances, it’s crucial to regularly reassess our treatment approaches. The paper discusses the use of certain devices in cataract surgery to control eye pressure, such as the CyPass, Kahook, and Xen45. It also suggests a strategy for deciding which surgery to perform, based on the patient’s specific needs and goals of care. The paper summarizes recent clinical evidence supporting the use of these devices.

FAQs

  1. What devices are discussed in the research paper for managing eye pressure during cataract surgery?
  2. Does the paper suggest a strategy for deciding which surgery to perform for patients with cataracts and glaucoma?
  3. What recent clinical evidence does the paper provide in support of the use of devices such as CyPass, Kahook, and Xen45 in cataract surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to follow all pre-operative and post-operative instructions provided by the surgeon. This may include using prescribed eye drops, avoiding strenuous activities, and attending all follow-up appointments to monitor eye pressure and healing progress. Adhering to these instructions can help ensure the best possible outcome after glaucoma surgery.

Suitable For

Patients who are recommended glaucoma surgery typically have:

  • High intraocular pressure that is not well controlled with medication
  • Progressive vision loss despite using glaucoma medications
  • Severe damage to the optic nerve
  • Intolerance or allergies to glaucoma medications
  • Desire for a more permanent solution to manage their glaucoma

It is important for patients to discuss their individual situation with their ophthalmologist to determine if glaucoma surgery is the best course of action for them.

Timeline

Before glaucoma surgery:

  • Patient is diagnosed with glaucoma and undergoes various tests to determine the severity of the condition.
  • Patient may try different medications or treatments to lower eye pressure, but surgery is recommended if these methods are not effective.
  • Patient meets with their ophthalmologist to discuss the different surgical options available and the potential risks and benefits of each procedure.
  • Pre-operative tests and evaluations are performed to ensure the patient is a suitable candidate for surgery.

After glaucoma surgery:

  • Patient undergoes the surgery, which may involve creating a new drainage pathway for fluid to leave the eye or implanting a device to help regulate eye pressure.
  • Patient is closely monitored in the immediate post-operative period to ensure the surgery was successful and to watch for any complications.
  • Patient may experience some discomfort or blurred vision in the days following surgery, but this typically improves over time.
  • Patient follows up with their ophthalmologist for regular check-ups to monitor eye pressure and the effectiveness of the surgery.
  • Patient may need to continue using eye drops or other medications to manage their glaucoma, even after surgery.

What to Ask Your Doctor

  1. What are the potential risks and benefits of glaucoma surgery for my specific case?
  2. How will the surgery affect my vision and overall eye health in the long term?
  3. What is the success rate of the specific surgical device being used in my case?
  4. How long is the recovery period, and what can I expect in terms of post-operative care?
  5. Are there any alternative treatment options for my glaucoma that I should consider before opting for surgery?
  6. How often will I need to follow up with you after the surgery for monitoring and potential adjustments to my treatment plan?
  7. What can I do to help ensure the best possible outcome from the surgery and manage my glaucoma effectively in the future?
  8. Are there any lifestyle changes or medications that I should consider before or after the surgery to improve my eye health?
  9. Will I need to undergo additional surgeries or procedures in the future to manage my glaucoma, and if so, what should I expect?
  10. Can you provide me with more information or resources about glaucoma surgery and post-operative care to help me better understand the procedure and its implications?

Reference

Authors: Rabin RL, Rabin AR, Zhang AD, Burney EN, Rhee DJ. Journal: Curr Opin Ophthalmol. 2018 Jan;29(1):88-95. doi: 10.1097/ICU.0000000000000444. PMID: 29064837