Narrow angle

[Simi1234]

My dad is 76.  He was told by the specialist that he has narrow angle & cataract.  He was told to do laser PI to prevent the glucoma first.  Just wonder if the laser PI is needed and is it will worsen the catarct situation since he plans to have the cataract removed at least 6-9 months later.

[Doreen Fazio, M.D.]

A YAG iridotomy will not worsen his cataract, but will open the anterior chamber angle and prevent a sudden attack of angle closure glaucoma.  If the cataract is significantly affecting your father's vision, then removal of the cataract will also open the angle and improve vision as well.  If he has the cataract surgery, he will not need the laser iridotomy.

[Simi1234]

The specialist told us it's better to go the laser to prevent glaucoma first so that the eye pressure will be under better control when she does the cataract surgery later.  Does it sound right?

[Simi1234]

Thank you so much for the comments.   Very much appreciated!  It's a great forum for medical advice.  

[Houman Vosoghi, MD]

Feel free to seek a second opinion from another glaucoma specialist (Dr. Ahmed is a famous one in Toronto but there are plenty of competent glaucoma specialists there) but if the first doctor diagnosed narrow angles, chances are he needs intervention.  He can either go through the cataract surgery now (despite the slight increased risk from the flomax) and not need the LPI or have LPI done now (very low risk procedure) and wait till whenever he wants to have cataract surgery.  Just because his pressures are normal now doesn't mean he won't have a glaucoma attack which could be devastating for vision.  I would not ignore this even in the short run.

HV

[Simi1234]

Thanks for your prompt response.  My dad has been taking Flomax for a few years.  His ophthamologist told him that he should do the Laser PI before the cataract surgery.   We were very worried as we don't want to have unnecessary complication from the PI sine his eye pressure is normal and the PI was just for prevention.  Do you think we should seek another specialist?  We live in Toronto.