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glaucoma and cataract, surgery for treatment, heart patient, CABG surgery, normal sugar and BP

My father, aged 74 years, is suffering from glaucoma and cataract on both eyes. It has been detected in 2010. Till now he has been under medication to control glaucoma. However, now his opthalmologist is suggesting a surgery to remove cataract and along with that also do a surgery for glaucoma (Phaco/ SICS IOL + Trab). The prescriptions and reports are attached with this. My father is also a heart patient having undergone CABG in 1997 and currently under medication for heart (Deplat 75 and Atorva 10). Hence the surgery is advised to be done under the observation of a cardiologist . His BP and Blood Sugar (both Fasting and TP) are within normal limits. My father, however, can see reasonably well in both the eyes as of now. Would you recommend the above surgery under the conditions described above.
Asked On : Sun, 22 Apr 2012
Answers:  4 Views:  141
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Ophthalmologist 's  Response
Hi Atanu Ghosh,
The management of glaucoma is quiet a challenging one and it differs between ophthalmologists. If your ophthalmologist has been treating your father for the past two years he would have monitored the eye pressure ,the condition of the optic nerve and the retinal nerve fibres, the visual field damage during his reviews.

And the decision to do combined surgery counts on a number of factors like
- The stage of glaucoma and it's control with topical medications .
- The target eye pressure ,as decided by your ophthalmologist.
- The general health of the patient and his age( to avoid multiple visits for surgical intervention) ESP in your father being a cardiac pt.
- the post op inflammation and recovery time should also be kept in mind.
- the combined surgery controls the eye pressure better and SOMETIMES reduces or eliminates the need of topical medication.
So,considering all this , I think you should go ahead with a combined surgery as per your ophthalmologist.
Hope this helps.
Answered: Wed, 30 May 2012
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Ophthalmologist Dr. Swapnil Bhalekar's  Response
Considering yours fathers age I would advice only cataract surgery which can be performed under local or topical anesthesia very easily under anesthesia control of vital parameters. If his eye pressure is controlled on medications I would not advice combined surgery for him.
And as you are saying if his vision is good and he is not having any problem and pressure is well controlled on medical therapy, don't go for the surgery unnecessarily. Hope this will help you
Answered: Sat, 26 May 2012
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Cardiologist Dr. Ashutosh Kawade's  Response
Hi! After carefully & thoroughly going through your description of the problem, I would suggest you that you must follow the advice given by your ophthalmologist urgently!
Development of glaucoma in case of your father is what is known as a closed angle glaucoma, which must be surgically managed as early as possible, considering the high risk of becoming permanently blind due to a serious & irreversible damage to the optic nerve.
So, it is considered to be an emergency to operate & you need not have to worry because of the tremendously advanced methods of the surgery.
Thanks & wishing an early recovery of your father & a successful surgery!
Answered: Thu, 10 May 2012
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Ophthalmologist Dr. Swapnil Kothari's  Response
Hii Mr Ghosh,

I can't see the reports that u have attached. Are you able to view them in your view?

And as i said earlier, Dr Vidya has hit the nail on the head. I dont need to add anything more to her comments.
Answered: Thu, 31 May 2012
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