Combined cyclodialysis and cataract surgery

Glaucoma patients who require surgery for cataract may be treated with a combined surgical procedure. The purpose of this study was to determine the effectiveness of combining cyclodialysis with self-sealing, small incision cataract surgery for patients with cataracts and glaucoma.

This was a retrospective study. Fifty consecutive patients who had undergone the combined surgical procedure in 1992 or 1993 were identified. The patients were observed through the medical charts to determine when treatment failure (lack of improvement in intraocular pressure [IOP] control) occurred. The routine clinic examination schedule for the cases was generally at 1 to 2 days, 1 to 2 weeks, 1 to 2 months, 3 to 4 months, 5 to 6 months, 8 to 9 months, 1 year, and at yearly intervals thereafter. The rates of treatment failure and mean time to failure were determined using life-table methods. IOP control status at the final available follow-up examination was summarized for the group.

Thirty-seven of the 50 patients (74%) had a successful result. At the final available follow-up, 31 of these patients (62% of the entire cohort) were without all medications while maintaining IOP control. The other 6 patients demonstrated improved control by either requiring less medication to maintain control or by improving from the baseline level while being treated with medication. The reduced pressures appeared to be stable and maintained throughout a median follow-up time of 29 months.

Combining cyclodialysis with small incision cataract surgery has been successful in a high percentage of cases in the author's experience. It has become the procedure of first choice for patients with cataracts and glaucoma.