Simultaneous surgical management of cataract and glaucoma

This paper reports and analyses 70 combined cataract and trabeculectomy operations carried out on 50 patients by the two authors from 1973 to mid 1979. Control of glaucoma was achieved by surgery alone in 86%, the remaining 14% required additional medical therapy to achieve control. This therapy was less than that used preoperatively. Where the preoperative control was good 96% achieved post operative control without therapy. In eyes with poor preoperative control, 80% achieved post operative control without therapy. The complication rate was low and no eyes were lost in the series. The literature for alternatives for managing cataracts and glaucoma has been reviewed and analysis of this shows the following percentage control by surgery without additional medical therapy. (a) Cataract extraction alone 40.5%. (b) Drainage procedure followed by lens extraction 65.5%. (c) Combined cataract and glaucoma surgery other than trabeculectomy 79%. (d) Combined cataract and trabeculectomy 91%. The latter combined procedure is recommended for all eyes with coexistent cataract and glaucoma.