[Synthetic lens implantation in cataract patients with glaucoma]

In 178 eyes (122 patients) with chronic glaucomas an extracapsular cataract extraction was performed in combination with an implantation of a posterior chamber lens. In 45 cases a filtrating glaucoma surgery had been performed before. A narrow pupil, caused by the miotic therapy, posterior synechias or changes after glaucoma surgery, made the cataract extraction difficult in most of the cases. The variations in the operation techniques which thereby became necessary are discussed. 0.5 to 4 years after the lens implantation visual acuity, visual field, ocular pressure and glaucoma medication were investigated. The postoperative results and the late results were very satisfying. Not only the increase of the visual acuity was essential especially for patients with defects of the visual field but also the therapeutic effect on the intraocular pressure. After the posterior chamber lens implantation significantly (p less than 0.001) more eyes had a well regulated intraocular pressure under 20 mmHg (87%) at the time of the late investigation than preoperatively (63%). 33% had to use the same medicaments as they had before, 2% had more, 64% less medicaments. Altogether 56% of the eyes did not need any topical therapy at the time of the late investigation. So even in the case of insufficiently regulated glaucomas we do no longer primarily perform an extracapsular cataract extraction together with the implantation of a posterior chamber lens combined with a goniotrephining surgery (Elliot-Fronimopoulos).