An evaluation of three surgical approaches for coexisting cataract and glaucoma

Seventy-eight eyes of 69 patients with coexisting cataract and glaucoma underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation by one surgeon. A combined guarded filtering procedure was performed in 22 of these cases, and a two-stage procedure filtering surgery followed by cataract extraction was performed in 22 more. Cataract surgery alone was performed in the remaining 34. Since different criteria were used for selecting one of these three surgical approaches, and since baseline values in the three groups were not comparable, the significance of the results is limited. Observations of possible clinical significance, however, include the following: there were fewer early postoperative intraocular pressure rises associated with the combined procedures than were associated with cataract surgery alone, but there was an otherwise relatively lower complication rate in the latter group. All three groups had similar final intraocular pressures, although eyes undergoing the two-stage procedure, having had higher baseline pressures than those in the other two groups, had a higher percentage pressure reduction.