Extracapsular cataract extraction with posterior chamber lens implantation in patients with glaucoma

Forty-six patients with medically controlled open angle glaucoma were scheduled to undergo extracapsular cataract extraction with implantation of a posterior chamber intraocular lens. Surgery was performed in 43 eyes; three eyes had an intraoperative complication that prevented a posterior chamber lens implantation. The mean preoperative intraocular pressure was 17.6 mm Hg with the patients receiving a mean of 1.9 medications. The mean intraocular pressure (16.2 mm Hg) and the number of medications (1.4) administered to the 43 eyes having the planned surgery were significantly decreased an average of 23.4 months following cataract surgery. Seventy-two percent of the eyes had a postoperative visual acuity of 20/40 or better. Operative complications were similar to those reported for the same type of cataract surgery in nonglaucomatous eyes. However, there seemed to be an increased incidence of postoperative cystoid maculopathy (11.6%) in these glaucomatous eyes compared with previous reports in the literature and with the incidence in nonglaucomatous eyes that we treated. Our study shows that extracapsular cataract extraction with a posterior chamber lens can be effective in restoring vision without compromising intraocular pressure control in eyes with preexisting open angle glaucoma.