Q&A: Im a glaucoma patient and had a trabeculectomy done. Can I get eye corrective surgery like Lasik?

Question by altechworks: Im a glaucoma patient and had a trabeculectomy done. Can I get eye corrective surgery like Lasik?
After the trabeculectomy surgery my eye’s pressure is stable. Are there other Laser correction options I might use?

Best answer:

Answer by Garvin
I’m not a surgeon, but I think you may still be a candidate for laser surgery, just not traditional Lasik.

During the Lasik procedure, the pressure in the eye is intentionally raised for the flap to be cut. This raise in pressure is important to the procedure, but not healthy for the eye, especially in someone with advanced glaucoma. Newer Lasik procedures have a “blade-less” or “all-laser” of cutting the flap. PRK is another type of laser surgery that does not cut a flap at all. These options may be safer for someone with glaucoma.

All that being said, generally people that have needed a trabeculectomy have pretty serious glaucoma. Many surgeons may be unwilling to operate.

Many laser centers offer free consultations. Call to find out if that’s the case with a laser center near you.

Good luck!

Know better? Leave your own answer in the comments!

Lasik: Some Facts You Should Know Before You Undergo a Lasik Surgery

Are you someone who is nearsighted or farsighted, have you ever felt the frustration or inconveniency in having to wear glasses or contact lenses? Try LASIK or Laser-Assisted in Situ Keratomileusis! LASIK is a surgical procedure that can reduce a person?s dependency on glasses or contact lenses by permanently changing the shape of the cornea (the delicate clear covering on the front of the eye).

??????????? In order for a person to be able to view images clearly, their eye?s cornea and lens must be able to refract light rays properly so that images are focused on the retina. If these light rays aren?t clearly focused on the retina, they will see blurry images. This blurriness is called a ?refractive error? and is caused by an imperfect eyeball, cornea or lens. LASIK helps solve this problem by using an Excimer laser which is an ultraviolet laser to precisely remove corneal tissue to correct the shape for better focusing.

??????????? LASIK eye surgery is often performed on people who have nearsightedness or myopia, but is sometimes used to correct farsightedness and astigmatism. By using the Excimer Laser, the technology is able to correct nearsightedness up to 12.00D with -4.00D of astigmatism, and farsightedness from +1.00 to +6.00 with 1.00D of astigmatism. (Diopter, symbol D, is the measurement of the refractive error. A negative D value indicates nearsightedness and a positive D value indicates farsightedness.)

Before having a LASIK eye surgery, a complete eye examination is done to make sure your eyes are healthy. Doctors will then make sure that there are no irregularities that would prevent having a LASIK by measuring the curve of the cornea, the size and position of the pupils and the shape of the eyes. They will also make sure that there will be enough tissue left after the cornea is cut and reshaped by measuring the thickness of the cornea. The surgical procedure takes place within the consciousness of the patient, using only a mild sedative and anesthetic eye drops. The surgical procedure will take only 10 to 15 minutes for each eye and may be done on both eyes during the same session.

But before you think of going for a LASIK eye surgery, there are several things you must consider before undergoing the procedure. First of all you must be at least 18 years old since the vision of people younger than the age of 18 still continues to change. You should also not be pregnant or nursing and not taking certain prescription drugs that may interfere with the laser vision correction results. People with diabetes, rheumatoid, arthritis, lupus, glaucoma, or cataracts are not recommended to undergo the procedure as well. Mind that you should carefully weigh the risks and benefits based on your own personal value system and fully understand all the potential issues and complications.

LASIK is a good solution for people with nearsightedness and farsightedness. Surveys have also determined that most patients are satisfied with the results. You too may be satisfied from the procedure, but this only depends on your expectations and your research on the subject.

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Reasons to Avoid Lasik Surgery

Lasik surgery has helped many people correct their vision problems. As the technology advances it is becoming accessible to even more people and is becoming more popular as the way to correct vision problems. However, lasik surgery does still have some risks and the procedure is not for everyone. Take the time to learn more about lasik and see if it’s right for you.


The best candidates are those with astigmatism, nearsightedness and farsightedness. Whether you should choose lasik or another vision correction method depends upon your own vision problems, your overall health and what condition your eyes are in now. Eye surgery clinics will conduct a pre screening to determine if lasik is right for you.


As is the case with any surgery, lasik does come with risks. The final results will vary from person to person, the surgery may not take or you may have a situation where your vision is over corrected or under corrected leading to additional surgeries.


There are ways that you can reduce the risks inherent in laser eye surgery. Following the pre and post operative instructions of the surgeon is critical to the success of the procedure. While the doctor can make an accurate evaluation during the screening process, it’s up to you to follow through with any instructions or warnings given.


As the success rate of lasik surgery climbs, so does the number of professions that now allow for laser vision correction. Military personnel and pilots may now use lasik to correct their vision. Check with your employer to see if there are any restrictions they have regarding laser eye surgery before undergoing the procedure.


Part of the screening consists of a thorough eye exam where the surgeon will look for any conditions that might prolong your recovery or even disqualify you as a candidate for eye surgery. While certain things such as allergies will not disqualify you, you may need to wait until the condition passes before having laser eye surgery. Some other conditions such as glaucoma and cataracts can disqualify you completely as lasik is not appropriate to treat these conditions. In these cases you may be given alternative vision correction options.


While it may seem that there are many risks and problems with lasik, for the most part it is safe. As with any surgery, the final outcome is dependent on the patient and the condition being treated. Laser eye surgery surgery is not appropriate for everyone and it is partially your responsibility to make sure that lasik is right for you. If you do choose to have lasik surgery be sure to follow all of your doctors instructions.

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LASIK Eye Surgery What You Need to Know

If you wear glasses or contact lenses, chances are you have thought or even looked into LASIK eye surgery. This surgery has taken the optical world by storm, it promises to let you leave your glasses or contacts in the past, or at least to lessen your dependence upon them. As the procedure becomes more popular, it is easier to find a doctor or an office that will perform the surgery for you.

Before you decide that LASIK surgery is right for you, make sure that you know all the facts, and how they might affect you. LASIK (laser-assisted in situ keratomileusis) is a surgery that changes the cornea shape, this is a permanent change that is made using a laser and a special knife. This is what allows you to become fewer dependants upon your glasses or contact lenses as most wearers suffer from a misshaped cornea.

Before the surgery, you will need to consult with an optometrist that specializes in LASIK surgery. The doctor will conduct a number of tests to determine if you are a good candidate for the surgery. If it is determined that you are a good candidate, the doctor should be able to tell you how much of a change in your eyesight can be expected after the surgery.

Several things are taken into consideration when a doctor evaluates you for the surgery. For example, if you have had a change in your eyewear prescription within the last year, LASIK is not for you. The eyes need to be stable for at least a year, preferably longer to ensure that they aren’t going to change shape on their own. If you have a history of certain diseases, LASIK may not be the right choice for you either. Having a history of Glaucoma, Herpes, eye injuries or thin corneas, are a few of the reasons that would disqualify you for the surgery.

Now you have been checked out by a doctor and are ready to proceed on your road to a future without glasses. It is important that you know what to expect during the surgery as well.

When you go in for the actual surgery, you will be placed in a reclined position. You will receive a numbing solution in the eye that is being operated on. The doctor will use a special speculum to hold the eyelid open and a large machine with a microscope will be aimed at the eye. A ring will be applied to your eye with hard pressure, this is to create a suction affect on the cornea, the doctor will the use a knife to cut the part of the cornea that needs to be reshaped. Your vision will be blurred during this part of the procedure.

After the cornea has been cut the ring is removed, at this point, you will be able to see, although this will come and go during the rest of the LASIK surgery. This is the part of the operation where the laser is introduced, two actually. The first laser is for your eye to focus on; the second is the working laser.

The machine with the microscope is also attached to a computer. This computer is what controls the amount of strength that is available in the laser. Before the procedure, the surgeon will have programmed how much tissue needs to be removed from the cornea, based on the tests in the first visit. The computer then, stops the laser when the exact amount of tissue has been removed.

Your surgery is essentially done! There are a few rules for after the procedure that your doctor will go over with you, but most people are back to daily life within a couple of days.

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Reasons Why you May not Want to Get Lasik Surgery

Lasik can be the answer for many patients with vision problems. As medical advancement paves the way to safer, more precise procedures, laser eye surgery is becoming the preferred choice for vision correction. However, Lasik surgery is not for everyone. Learn more and determine if Lasik is right for you.

Patients who are nearsighted, farsighted or suffer from astigmatism may be appropriate candidates for Lasik. Depending on your overall health, the condition of your eyes and vision correction needs, an alternative laser eye surgery may be more appropriate. In order to determine if Lasik is right for you, schedule a Lasik prescreening exam with an experienced laser eye surgeon.

Risks, Responsibility and Lasik Surgery

Lasik, as with all surgical procedures, carries an unavoidable level of risk. Results vary for each patient and may not last. There is a chance that your Lasik surgery may result in over-correction or under-correction. Additional procedures, if applicable, may be required.

However, there are ways to significantly reduce the risk. Following preoperative and postoperative instructions from your Lasik surgeon is an essential part of your success. The doctor can make an accurate evaluation of your candidacy for Lasik during the screening process.

Your Profession and Lasik Surgery

With Lasik success rates continually improving, many careers and services that previously prohibited laser eye surgery are starting to come around. Pilots and members of the military may now qualify for Lasik. You must first check with your service or employer regarding any restrictions and conditions against laser eye surgery.

Refractive Instability and Lasik Surgery

Patients who experience refractive instability may need to postpone laser eye surgery until vision has stabilized. Common conditions that cause vision to fluctuate are Diabetes, pregnancy and nursing. If you are planning to conceive, wait at least six months after Lasik surgery.

Age is another determinant for refractive instability. You must also be at least 18 and without changes to your prescription for at least 12 months. Certain medications can also cause vision to fluctuate. Discuss all medications, including over the counter drugs and vitamin supplements with your Lasik surgeon.

The Health of Your Eyes and Lasik Surgery

As part of the screening, the Lasik surgeon will give you a thorough medical eye exam. Any eye conditions that may aggravate and prolong recovery will be evaluated carefully. The doctor will check for conditions such as dry eyes, conjunctivitis and allergies. You may need to wait until symptoms subside prior to laser eye surgery.

There are certain eye conditions that may disqualify you from Lasik altogether. Glaucoma, Keratonusus and cataracts may not be appropriate for Lasik. In this case, your laser eye surgeon can provide other alternatives to Lasik.

Lasik may not be appropriate for patients with thin corneas. The use of a microkeratome blade during Lasik can cause complications for patients with insufficient cornea thickness. Also, patients with large pupils may be at risk for problems with night vision and sensitivity to light after Lasik. If symptoms do not subside after six months, corrective surgery may be necessary.

Your Medical History and Lasik

In addition to evaluating the heath of your eyes, the surgeon will examine your overall health. Any conditions that lower immunity, such as Rheumatoid Arthritis, Lupus, HIV and other immunodeficiency states can be a serious hindrance to the healing period. Medications like steroids and retinoic acids also affect immunity.

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Does Lasik Correct Glaucoma?

Glaucoma. Such fear-inducing word when it comes to our vision, or lack there of. Although no one really likes getting the puff-of-air test during their eye exam, they all would take that over being diagnosed with glaucoma later, no doubt.

But what is glaucoma really? Most folks just hear the word and think ?can?t see anymore?. That may be the case if it is never treated but a lot happens before blindness actually would occur. In truth, glaucoma is an increase in intraocular pressure in the eye including behind the cornea. Over time, if left untreated, that pressure can rise to dangerous levels and damage your optic nerve. This damage can result, initially, in decreased peripheral vision. If still untreated, blindness can be the final result.

The build up in pressure can stem from a disease such as diabetes, or it may not be draining properly. Either way, it indicates a problem that your ophthalmologist should be treating. If you aren?t getting your eyes checked regularly, it may be too late to stop the disease once you finally notice symptoms such as your peripheral vision getting worse.

As for the cornea, it is normally thick enough to maintain its curve against the pressure. Some people, however, have thinner corneas. Thin corneas are not good candidates for LASIK surgery for exactly that reason ? they are thin. The LASIK procedure requires that a little corneal tissue be removed. An already thin cornea may not have the ability to holds it own against the pressure of the naturally occurring eye fluids. You don?t want to weaken an already weak structure.

Glaucoma symptoms that your eye doctor can look for include:

  • High intraocular pressure<br>
  • Reduced visual fields<br>
  • Damaged optic nerve<br>

Symptoms that you should be aware of include:

  • Headaches when reading or entering a dark room<br>
  • Haloes around lights<br>
  • Misty vision<br>
  • Eye aches after vigorous activity<br>
  • Missing pieces in your visual field such as first letters of words<br>

These symptoms don?t automatically imply that you have glaucoma but they certainly indicate that a visit to your eye doctor is warranted sooner rather than later. Treatments are available and can be as simple as using prescription eye drops on a strict basis or as serious as glaucoma surgery.

Take good care of your eyesight. It is a sense that people greatly miss when they lose it. Pay attention to how your eyes feel and how you see what is around you. And, of course, visit your optometrist or ophthalmologist regularly. They are the experts and can help with whatever may happen.

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How Safe Is Lasik Eye Surgery In The Elderly Years ?

It’s a pretty well-established fact that most people experience a decline in the quality of their vision when they hit their forties. And, with a very large population of baby boomers now in their forties and above, the demand for corrective eye surgery to help improve these common vision problems has been on the rise. But many senior citizens question if it is worth it to have Lasik eye surgery in their later years.


The answer, according to experienced ophthalmologists and laser eye surgeons, is that people are eligible for laser eye surgery at just about any stage of life. Those experiencing problems with their eyesight can enjoy improvement with correction laser vision surgery. The main vision problems that can be improved with corrective eye surgery are astigmatism, far-sightedness and near-sightedness.


Lasik eye surgery in virtually any stage of life is considered a very low risk procedure, overall. But, there are a few precautions that doctors recommend to those who are a bit older. One common condition that the elderly deal with is eye dryness and therefore, after Lasik eye surgery, the elderly are strongly encouraged to take extra care to be sure to keep the eyes well-hydrated and lubricated with eye drops.


Lubrication of the eyes after Lasik eye surgery is not only important for those who are having the procedure done in their later years. Keeping the eyes moist and keeping them from drying out is an important part of aftercare for everyone who has undergone corrective eye surgery, but it is even more crucial for the elderly and for anyone who tends to naturally have dry eyes.


Using eyedrops routinely after the corrective procedure is a very simple, yet very effective way to avoid problems and complications. The laser eye surgery clinic will provide the patient with the proper lubricating eye drops for post-surgery use.


One of the reasons why eye surgery in the later years is still safe and effective is because overall the procedure has proven to have very few complications and has very low risk. This is because the surface of the eye is not cut with traditional surgical instruments, which can cause damage to the cornea.


Instead, the small cut that needs to be made is accomplished with a laser beam. This means the incision will be tiny, accurate and extremely clean. All of these factors result in much less risk of infection and other complications.


However, even with a very good track record of success, eye surgery in general is not completely foolproof. Corrective eye surgery patients experience complications from the procedure or disappointing results approximately 5% of the time. When the procedure does not go well, the patient might end up having fluctuating vision, seeing halos around light sources, having increased sensitivity to glaring light, and possibly experiencing more dryness of the eyes.


Even though most laser eye surgeons are in agreement that Lasik eye surgery in the later stages of life is still a viable and effective option, they also mention that Lasik vision surgery is not the right procedure for everyone. There are conditions, such as glaucoma and presbyopia, which will not be corrected through laser eye surgery. In fact, with glaucoma, such a procedure can even worsen the condition.

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California Lasik Eye Surgery & Vision Correction

When it comes to caring for your eyes and eyesight, regular visits to a good eye doctor are essential. An eye test every 2 years is a good idea.

During those check-ups, the eye doctor will examine your eyes not only for acuity of vision, but also for early signs of certain eye problems which can creep up on us quietly and steal our eyesight. As we approach the age of 40, it?s time to pay more attention to these possibilities.

Here are some eye diseases to ask about.

Glaucoma

? Ask your eye doctor for a glaucoma pressure test.

Glaucoma is the name for a group of eye conditions related to the pressure inside the eyeball (intraocular pressure). Our eyes need a certain amount of pressure to work correctly, but in glaucoma, that pressure is increased.

The higher pressure causes no discomfort or pain

Without a pressure test done by an eye doctor, we wouldn?t know the pressure had increased. But it works silently to damage the optic nerve, where it leaves the eyeball to carry visual information to our brain.

What increases the intraocular pressure in glaucoma is blocked drainage.

? Normally, the eye fluid (aqueous fluid, unrelated to tears) can drain from the eye back into the bloodstream by seeping through tiny channels in the inside corners of the eyes.

? As fluid is created, some drains out, keeping the intraocular pressure even and steady.

When the aqueous fluid is blocked from draining out enough to balance the new fluid being created, the intraocular pressure rises, progressively damaging the optic nerve, and causing us to gradually become blind.

Detached retina

? Ask for a full eye examination to check on the condition of the retina.

Our eyes are like little cameras and the retina is like the film. It?s the inside back surface of the eye, where images are formed of what we see, and are then transmitted as electrical activity to the brain, by the optic nerve.

If the retina is at all weakened, for example by a little hole or tear, then gradually the eye fluid (intraocular fluid) can leak underneath it and cause it to peel off.

When it?s not smoothly lining the back of the eyeball, it stops functioning well as the film in this little camera. Images deposited on it are now blurry or dim.

Aside from blurriness, you might notice

? A shadow encroaching on your vision on one side;

? Occasional bright flashes; and/or

? Showers of dark spots (floaters).

If these symptoms become more severe and you notice any diminishing of your vision, see an eye doctor immediately, to avoid progressive damage to your eyesight.

This condition can be treated, either by a laser or a freezing treatment, if it?s caught early enough. If not, surgery under general anesthesia will be needed.

Cataracts

? Ask what might be the cause of your visual symptoms.

Just as a camera has a lens which focuses light onto the film, so our eyes have a lens which focuses light onto the retina at the back of the eye.

Sometimes, most often as we age, the lens can become cloudy. This will impair our vision, and cleaning our glasses will be of no help.

Symptoms

? Lights may become too bright, dazzling you

? Colors may start looking faded

? Things may look misty or dim

If you find that you?re having trouble with driving, reading, using the computer, or any other activities that require good visual acuity, see an eye doctor without delay.

Uveitis

? Ask what?s causing this inflammation in your eyes and whether it can be cured.

The uvea is the middle layer of tissue around our eyeball, with the outer layer being the sclera (including the cornea), and the inner layer the retina, which is at the back, but also curves around towards the front of the eye.

The uvea can become inflamed in a number of ways that are different in each individual. There are many causes for it, many ways it can affect other parts of the eye, and some other conditions in the body that it can relate to.

The term intraocular inflammation is used to include all the variations. There are many tests that your eye doctor could run, depending on how the uveitis appears in your case.

Treatment goals

? If there?s pain or discomfort, to relieve it

? Preventing loss of eyesight

? To address the cause, if that?s possible

Your eye doctor may prescribe some type of eye drops, or corticosteriods, or some newer drug. Once it occurs, uveitis tends to stay, and must be controlled when it can?t be cured.

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How Does Lasik Surgery Affect Glaucoma?

Many people who have the desire for Lasik surgery are worried about getting it, because they also have glaucoma. They become concerned that they will damage their eyes through Lasik or that the procedure will make their glaucoma worse. While it is understandable that a person is worried about his or her eyesight and wants to protect it, many concerns about Lasik can be alleviated by talking to an eye doctor and having one?s questions answered. By doing this, a patient can make the best and most informed decision, leading to the best outcome, whatever the decision is.

What is Glaucoma?

Glaucoma is an eye disease that causes a gradual loss of vision. It is generally caused by high intraocular pressure (the pressure inside the eye). However, it is important to remember that the thickness of a person?s cornea and other factors can affect eye pressure. What is high to one person might not be high to another person, so checking it over time and watching carefully for any damage or risk factors is important. High intraocular pressure that is uncontrolled and not ?normal? for a person — someone with thicker corneas, for example, will generally have higher eye pressure — can cause a deterioration of the optic nerve. A person will notice that their peripheral vision becomes less and less, and eventually, if not treated, the person will be looking ?through a tunnel? before losing vision completely.

There is Good News

There is some good news on two fronts. First, glaucoma is treatable. Once vision is lost, it cannot be recovered. However, the vision that has not yet been lost can be saved through prescription medications that stop or drastically slow the progression of the disease. Second, there is no evidence that Lasik surgery either causes glaucoma or makes it worse. The Lasik procedure deals with the cornea of the eye, as opposed to dealing with the inside of the eye. Since the intraocular pressure is inside the eye, it is not affected by it. The only ?concern? is that the pressure in the eye after Lasik may read lower than it actually is, so an eye doctor should be made aware of this. Beyond that, however, there are no other concerns when it comes to Lasik and glaucoma.

The Lasik Procedure

The procedure that takes place during Lasik is a relatively simple one. The patient is given a sedative if needed, and anesthetic drops are placed in the eyes to numb them. The eye is held open with a gentle restraint and a flap is cut in the corner. Sometimes this is done with a blade, but more and more people are offering bladeless Lasik, meaning that the laser is used to cut the flap. After the flap is cut and folded back, the laser is used to reshape the inner layers of the cornea. When the laser is done, the corneal flap is put back into place and begins to heal almost immediately. Medicated eye drops are given to the patient to put in his or her eye, and specific after-care instructions are also given, so that the chance of any kind of complication will be reduced. The entire Lasik procedure takes about 15 minutes, and is considered to be extremely safe.

For more and more people, Lasik is becoming the option that they choose to correct their vision. It is much safer than it used to be, and there are fewer complications as well.

Recent studies indicate that laser eye surgery has now surpassed contact lenses for safety, which means more people will likely be getting the surgery. For example, for someone who has glaucoma, there is no need to worry about Lasik making it worse or causing any kind of problem.

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Introduction To Lasik Eye Surgery

Lasik eye surgery is used to cure three main types of eye conditions-myopia, hyperopia and astigmatism. myopia, also know as nearsightedness is the problem of not being able to see what is far away without glasses. hyperopia, also known as farsightedness, is the other way round. Astigmatism is something different where the patient has irregularities in his cornea which as a result distorts the image formed on the retina of the eye.


This surgery has been embraced by many a patient over the last decade to correct some specific eye defects. It has caught the imagination of people and has been gaining popularity every year. But this surgery does have its own effects and it varies from one patient to another. So before you actually decide on getting a eye surgery done, you should always consider the pros and the cons.


Operation comes with its own set of risks and they should always be considered seriously before you actually sign-up for an operation. Problems that might be caused due to this eye surgery are double vision, glare, and halo. One’s nighttime vision can also be affected, especially for certain operation procedures. Even permanent blurry vision and diminished contrast may be the effects of this operation.


There are a few basic things that any optometrist will look for before a this surgery. That would primarily include your eye health history. In case of a particular few diseases the chances of you undergoing a surgery will significantly decrease. These would include glaucoma, herpes, eye injuries or thin corneas. Any of these conditions can disqualify you as a suitable candidate for this operation. Another important criterion is whether there has been an alteration in your eyewear prescription over the last year. Before a operation of your eyes should be steady. If they are not then the optometrist might just postpone the surgery for a few months until he is satisfied that your eyes are ready to undergo that surgery.


As more and more people opt for this eye operation, the costs for the same are going down every day. But still the price might be a bit too high for many to bear. On an average one needs to pay around $1800 for the surgery of a single eye.


Laser eye surgery essentially falls into two categories: photorefractive keratectomy, and lasik, or laser assisted in-situ keratomileusis. These two types of laser surgery have been modified to create variations on the same theme. Lasek as opposed to lasik is a more modern version of pkr. All these procedures are conducted with the patient fully conscious, and drops are used to dull any sensations in the eyes.


Not everyone with eye defects is the ideal candidate for laser surgery. The risks involved are many, and serious enough not to ignore. An educated choice is always the best way to proceed.

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