Combined procedure for glaucoma and cataract: a retrospective study

To ascertain the long-term effects of a triple procedure in the case of coexisting cataract and glaucoma, we did a retrospective study of 93 eyes that had cataract extraction, IOL implantation, and trabeculectomy within a ten-year period. Mean follow-up was 32.4 +/- 21.9 months. Mean postoperative intraocular pressure (IOP) was significantly lower than preoperatively, even though fewer medications were being used. One year after surgery, 60% of eyes had a best corrected visual acuity of 20/40 or better with an average improvement of 3.8 Snellen lines. Patients who had had surgery four or more years before the study had the highest percentage of eyes with an IOP exceeding 22 mm Hg. This group also had the poorest IOP control when no medications were used and when the patient took fewer medications than before surgery. The finding that IOP control decreases with postoperative time raises questions about the long-term success of the triple procedure in controlling IOP.