Will I need Glaucoma surgery?

[aman_gr]

I was involved in a car accident in july 2018, and my left eye got seriously injured. It wasn't a penetrating injury, but a small rock did hit my eye very hard. Since then I have been on pressure lowering medication since my IOP went pretty high. The doctor said normal IOP range is between 12 and 22, and my IOP has been 25+ continuously since then. But my IOP sometime drops to normal range of 18 and 15 (only happens when I am on Glycerol OS syrup). But my doctors say I can't be taking Glycerol my whole life so I will need a conventional Glaucoma surgery to lower my IOP and preserve of what's left of the eye.

I admit my eye sight has gone down since the accident, but it has been steady for the past 4 months. The doctor says IOP of higher than the normal range of 22 will affect my eye sight in the future. But since the eye sight is constant and same for the past 4 months even after IOP recorded of 28, 32 and eve 35 sometimes. I just wanted to ask if I will need a Glaucoma surgery?

I am reluctant of this surgery because as far as I have researched on the internet, this surgery (trabeculectomy) is not very successful in Traumatic Glaucoma and in young age too. So I just need a second opinion before I opt for surgery. P.s. I am 26 yrs of age.

[JohnHaganMD]

Where do you live?  Trabeculectomy surgery is old technology having been "new" about 1974.  The newest surgery and what you should have if you need it is MIGS  (Micro Invasive Glaucoma Surgery).  Also there are 2 new glaucoma medications out so now a total of 6 different families of medications that work together.  So you should have been on a trial of 2-4 of these together.   You need to see the most well trained glaucoma specialist you can get back and forth in a reasonable amout of time. But again trabeculectomy is OLD TECHNOLOGY and is not done in USA and EUROPE and other advanced countries anymore.

[aman_gr]

Thanks for the reply. I live in India and I have visited 6 different doctors in the last 4 months and all of them suggested me Trabeculectomy. I guess MIGS isn't done in India or at least one of the doctors I went to see should have suggested me this.

[JohnHaganMD]

India has very advanced medical care but not for the general population and its concentrated in medical centers and specialists that serve the wealthy.   Try and find a medical center/medical school with an ophthalmology program and a glaucoma specialist.   Use the internet search engines:  This is a LINK from 2016 that shows Indian Glaucoma specialists learning to do MIGS    https://timesofindia.indiatimes.com/india/Indian-doctors-learning-to-use-micro-incision-glaucoma-surgery/articleshow/50679572.cms    

[aman_gr]

Thanks again. So it is confirmed that I will need a Glaucoma surgery (Trabeculectomy or MIGS)?

[JohnHaganMD]

That is not something I can confirm over the internet.  But IOP of 28-35 is too high.   If it can't be controlled with eyedrops (likely several different types) then surgery is likely necessary.  Traumatic glaucoma doesn't respond to laser well (SLT)