Triple procedure of extracapsular cataract surgery, posterior chamber lens implantation, and glaucoma filter

A triple procedure consisting of extracapsular cataract surgery, posterior chamber intraocular lens implantation, and glaucoma filtering operation was performed in 30 eyes of 28 patients. The follow-up time was six to 24 months, with a median of 11 months. Group I consisted of 21 eyes with advanced glaucoma and poor to marginal pressure control. After surgery, the pressure was less than or equal to 21 mm Hg in 62% but 86% still required medication. This intraocular pressure control is worse than that reported by others. Group II consisted of nine eyes with a functioning filtering bleb before surgery. The incision was made through the filtering bleb in order to facilitate the cataract surgery. A new filtering procedure was performed adjacent to the original one. There was loss of control in a significant number of eyes but, with rare exception, no better or worse than that reported with other approaches. In pseudophakia there is a poor correlation between pressure control and a visible bleb. The visual results for both groups were good, with 73% obtaining 20/40 or better visual acuity.