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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Cataract surgery in the glaucoma patient.

Jennifer S Kung1, Daniel Y Choi1, Anjum S Cheema1

  • 1Byers Eye Institute, School of Medicine, Stanford University, California, USA.

Middle East African Journal of Ophthalmology
|January 28, 2015
PubMed
Summary

Cataract surgery can significantly lower intraocular pressure (IOP) in glaucoma patients. Performing cataract surgery before glaucoma surgery offers benefits, while after trabeculectomy it risks filtration failure.

Keywords:
CataractGlaucomaSurgery

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Innovation

Background:

  • Glaucoma and cataracts frequently coexist.
  • Cataract surgery's impact on intraocular pressure (IOP) in glaucoma is a critical consideration.
  • Managing patients with both conditions requires careful therapeutic and diagnostic planning.

Purpose of the Study:

  • To review the role of cataract surgery in glaucoma patients.
  • To analyze the effects on intraocular pressure (IOP).
  • To discuss diagnostic and therapeutic strategies for coexisting glaucoma and cataracts.

Main Methods:

  • Literature review of recent evidence on cataract surgery in glaucoma.
  • Analysis of diagnostic and therapeutic considerations.
  • Evaluation of surgical sequencing and combined procedures.

Main Results:

  • Cataract extraction shows potential for significant and sustained IOP reduction in open-angle, ocular hypertension, and angle-closure glaucoma.
  • Cataract removal can enhance the interpretation of perimetric testing.
  • Performing cataract surgery before glaucoma surgery is generally beneficial, whereas post-trabeculectomy cataract surgery increases filtration failure risk.

Conclusions:

  • Cataract surgery offers IOP-lowering benefits for glaucoma patients.
  • Optimal timing and sequence of cataract and glaucoma surgery are crucial for success.
  • Combined cataract and minimally invasive glaucoma surgery present evolving options for early to moderate glaucoma.