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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8351
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My wife has non small cell lung cancer,and has been treated

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My wife has non small cell lung cancer,and has been treated with carboplatin and paclitaxel and avastin and now alimta.She also has gloucoma and was treated several weeks ago for a cateract combined with a flap procedure to stabalize pressure in the eye. The avastin was still in her system when the surgery was done, but the surgeon, whom I trust, did not feel it would be a problem. She has a pinhole in thc conjunctiva ,her vision is poor the pressure is sill low or cannot be measured. She has a soft contact over the pinhole as a "bandaid" . Her vision is a little better one day then the next day is not. Please suggest how and who best to treat this. Thank you.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Hi. I agree that the avastin, most likely, did not contribute to the pinhole in her conjunctiva. Use of a "bandaid" contact lens is the first step in the treatment of this condition and, in the majority of cases, fixes things.

Dr. Rick :

Do you know if your wife's anterior chamber is formed? It may not be of the normal depth right now, but as long as her anterior chamber is not "flat" there is no cause to be more aggressive in the treatment of her low post-op pressure at this time.

Dr. Rick :

Hi. Welcome to chat. Do you know if the surgeon used Mitomycin-C during her combined cataract and glaucoma surgery?

Dr. Rick :

It is also to be expected that her vision will continue to fluctuate while her eye pressure stabilizes....

Customer:

would the alimta cause a problem ? I do not know about the anterior chamber. She had lasix about 15 years ago. I do not think he used mitomycin c. Sorry about my slow responses, i am not a typist !

Customer:

please reply

Dr. Rick :

It is very common for there to be a small leak in the conjunctiva after a trabeculectomy, especially when combined with cataract surgery. I do not believe any of the medicines that your wife took, or is taking, contributed to this common, relatively minor, post op "complication". This is something that ophthalmologists who do glaucoma surgery deal with all the time.

Dr. Rick :

The reason I asked about Mitomycin-C is because, if it was used, it might just make the sealing of this pinpoint hole a little tougher in the long run but, once again, it is something that eye surgeons deal with successfully all the time. You really don't need to worry. It sounds like your wife is in good hands with her eye doctor.

Customer:

Please comment on prognosis and a time frame for healing as surgery was in july

Customer:

thank you

Dr. Rick :

Ok.....well, a leak that has gone on for 4 months may need a little more aggressive approach :) That being said, if things have been getting a little bit better each time her eye was checked, her anterior chamber is formed and she doesn't have large choroidal effusions (in the back of her eye) it is still reasonable to continue with the bandage contact lens. The next step? Well, tissue glue is a thought as is going back to the OR and repairing the hole surgically. This, of course, has the risk of causing a new hole when fixing the current one. As a retina specialist it has been quite some time since I've personally done any anterior cataract surgery or any glaucoma surgeries........so, if you are still concerned and find yourself wondering if your wife's ophthalmologist is doing everything that can be done, I would suggest you consult with a glaucoma sub-specialist. Although, from what you are telling me I feel your wife is getting good care....even though the leak has been going on for some time.

Dr. Rick :

Does this make sense to you?

Customer:

yes,we will stick in there ! thanks for your help.

Dr. Rick :

My pleasure.

Dr. Rick :

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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8351
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
I wish your wife the best with her glaucoma surgery and her lung cancer :)

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Dr. Rick
Dr. Rick
Eye Doctor
8351 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest