A 40-year-old Asian gentleman with pathological myopia, bilateral retinal detachment surgery (both scleral buckle and vitrectomy) was referred to Ophthalmic Surgeon- Gurjeet Jutley by another consultant with the following clinical picture:
- Axial length of 30 mm
- Pressure of 30mmHg on quadruple drop therapy and maximal oral acetazolamide
- Cup-disc-ratio of 0.9 with advanced visual field defects
The consideration of the high myopia, previous retinal surgery and advanced glaucoma gave a difficult management decision:
- Leaving on medical treatment could lead to kidney problems
- Cyclodiode laser
- Tube surgery, with risk of choroidal effusion (fluid in the deeper layer of the eyes) and manipulating thin sclera
Outcome:
- We decided a tube surgery: two weeks after the operation:
- Unaided vision 6/9
- Pressure of 10 off treatment
- The right eye will be addressed shortly