[Intracapsular cataract extraction using cyclodialysis. A useful method]

Thirty patients requiring cataract extraction for improved vision, and having concurrent primary open-angle glaucoma controlled with varying success by medication, had combined intracapsular cataract extraction and cyclodialysis performed by one surgeon. The average duration of follow-up was 22 months. Visual acuity deteriorated in one case in whom vision was limited to finger counting preoperatively. This patient had very advanced glaucoma and severe optic nerve damage; loss of vision was due to progression of visual field loss involving fixation. Visual acuity was unchanged in three cases; 2 had fingercounting vision, while one patient could discern hand movement preoperatively. All these patients also had far-advanced glaucomatous field loss and one, in addition, had senile macular degeneration. In all other cases there was a significant improvement in visual acuity. The mean intraocular pressure preoperatively was 22.8 mm Hg; three days post-operatively it was 13.6 mm Hg, after three months 17.6 mm Hg, after one year 17.8 mm Hg, and at the final follow-up visit 14.4 mm Hg. The number of medications required to control intraocular pressure decreased markedly. Combined cataract extraction with cyclodialysis appears to be a satisfactory procedure where there is an indication for combined cataract extraction with a glaucoma procedure. It should not be used in candidates who have had previous inflammatory glaucoma or who are not expected to tolerate long-term usage of echothiophate eyedrops following surgery.