Our Summary

This research paper discusses a rare type of glaucoma that can occur after cataract surgery, known as phaco-antigenic glaucoma. The authors describe the case of an 82-year-old woman who experienced this condition in both eyes following her cataract surgeries. Despite receiving maximum medical treatment, her intraocular pressure (pressure inside the eye) remained high and she had to visit the emergency department six times within 11 days. Tests showed no signs of infection. Ultimately, a surgical procedure known as viscocanalostomy was performed on both eyes, which improved her vision and reduced the pressure inside her eyes. The authors highlight the importance of timely intervention in managing this rare complication.

FAQs

  1. What is phaco-antigenic glaucoma?
  2. What is the surgical procedure called viscocanalostomy and how does it help in cases of phaco-antigenic glaucoma?
  3. Why is timely intervention important in managing phaco-antigenic glaucoma?

Doctor’s Tip

A doctor might tell a patient about glaucoma surgery to ensure they follow all post-operative instructions carefully, such as using prescribed eye drops, attending follow-up appointments, and avoiding activities that could increase intraocular pressure. It is also important for patients to report any unusual symptoms or changes in vision to their doctor immediately.

Suitable For

Patients who are typically recommended glaucoma surgery include those with advanced stages of glaucoma that cannot be effectively managed with medications or other non-surgical treatments. This may include patients with high intraocular pressure that is causing damage to the optic nerve, leading to vision loss. Additionally, patients who are experiencing significant side effects from glaucoma medications or who have difficulty adhering to their medication regimen may also be candidates for surgery.

Specifically, patients with certain types of glaucoma, such as angle-closure glaucoma or secondary glaucoma (glaucoma that occurs as a result of another underlying condition or treatment), may benefit from surgical intervention. Additionally, patients with congenital glaucoma, which is present at birth, or neovascular glaucoma, which is caused by the growth of abnormal blood vessels in the eye, may also require surgery to manage their condition.

Overall, the decision to recommend glaucoma surgery for a patient will depend on their individual circumstances, including the severity of their glaucoma, their overall health, and their ability to tolerate and adhere to medical treatments. It is important for patients to work closely with their ophthalmologist to determine the most appropriate treatment plan for their specific situation.

Timeline

Before glaucoma surgery:

  1. Patient undergoes cataract surgery, which can sometimes lead to the development of phaco-antigenic glaucoma.
  2. Patient experiences symptoms such as increased intraocular pressure, blurred vision, eye pain, and redness.
  3. Patient receives maximum medical treatment, including eye drops and medications, to lower intraocular pressure.
  4. Despite medical treatment, patient’s symptoms persist and intraocular pressure remains high.

After glaucoma surgery:

  1. Patient undergoes surgical procedure such as viscocanalostomy to reduce intraocular pressure.
  2. Surgery is successful in improving patient’s vision and lowering intraocular pressure.
  3. Patient experiences improved vision and reduced symptoms such as eye pain and redness.
  4. Patient may require follow-up appointments and continued monitoring to ensure long-term success of the surgery.

What to Ask Your Doctor

  1. What are the risks and benefits of glaucoma surgery for my specific case?
  2. How will the surgery be performed and what is the expected recovery time?
  3. What are the success rates of this type of surgery for glaucoma?
  4. Are there any alternative treatments or procedures that I should consider?
  5. What are the potential complications or side effects of the surgery?
  6. Will I need to continue using eye drops or other medications after the surgery?
  7. How often will I need to follow up with you after the surgery?
  8. What lifestyle changes or precautions should I take after the surgery to protect my eyes?
  9. What should I do if I experience any pain, discomfort, or changes in vision after the surgery?
  10. Are there any specific factors about my medical history or current eye health that may affect the success of the surgery?

Reference

Authors: Chiu AKC, Mathews D. Journal: Eur J Ophthalmol. 2019 Jul;29(1_suppl):22-26. doi: 10.1177/1120672119858875. Epub 2019 Jul 8. PMID: 31282196