Thursday, October 8, 2009

Pigmentary Glaucoma laser surgery

My husband had laser surgery to relieve high pressure due to Pigmentary Glaucoma in mid-July. After the surgery, he developed severe pain in the eye, but the pressure was in the normal range. The doctor said that he was suffering from severe inflamation (inflammation). He was treated for the inflamation (inflammation) with drops, but it did not go away, and the pressure rose back up into the mid 30's, and he could not see out of the eye and was in severe pain. The doctor advised him to seek treatment at the U of M eye clinic in Ann Arbor immediately. The doctor at the U of M believed that the inflamation (inflammation) was due to the surgery, light, and an eye drop. I believe the name was Xylatan. She changed his medications and gave him some pills for two days to relieve the pressure. Since that visit, three weeks ago, the inflamation (inflammation) has not subsided, and now he is feeling pain in that eye again. The pressure is also rising again. It was 26 on the 9th, and today, the 16th, it was up to 32. I am writing because we dont know what to do. The doctor seems puzzled by his response to the laser treatment, and is notadvising any changes in medications. Do you have any advice? Thank-you for your time in this matter.

Inflammation after laser surgery is unusual but can sometimes happen. It is important to know what type of laser surgery he had (laser trabeculoplasty or peripheral iridotomy). It is also possible that the medications can be making the inflammation worse. For example, Xalatan has very rarely been associated with inflammation in the eye. It is reasonable to stop those medications which may cause inflammation and put him on pills and possibly steroid medicines.
It is possible that he has an underlying predisposition for eye inflammation (UVEITIS) and should have a through evaluation for this.
If medicines cannot control his eye pressure and if there is risk of optic nerve damage, he may require glaucoma surgery.
The most important thing is to maintain follow-up with your ophthalmologist. I am sure your husband is getting very good care at Ann Arbor. I am also a glaucoma specialist and if you would like another opinion, you can call my secretary at 313-916-3260 (Paula) and ask to see Dr. Imami. If you want another opinion, please bring a copy of your old records and visual fields.
This information is for educational purposes only. It is not possible to advise on treatment without examining your husband.