Abstract
Cataract and glaucoma are two of the leading causes of worldwide blindness, and as such they frequently coexist. When cataracts become visually significant and require surgery in a patient with concurrent glaucoma, three surgical options exist: performing cataract surgery alone; sequential surgery-performing glaucoma surgery first with the plan to perform cataract surgery at a later time; and lastly combined cataract and glaucoma surgery. Each of these options has its own set of advantages and disadvantages, and each one needs to be considered depending on the specific clinical scenario. Cataract extraction alone has been shown to decrease intraocular pressure and is a sufficient surgical option in many cases of open-angle and closed-angle glaucoma. Sequential surgery is most appropriate when the glaucoma is the dominant factor in the patient’s clinical picture, and lowering the elevated intraocular pressure takes precedence over removing the cataract, which may not be visually significant at that time. Combined surgery is appropriate when the cataract is visually significant, and the glaucoma is either uncontrolled or controlled on maximally tolerated medical therapy. Several new glaucoma surgical procedures have recently become available; however, the gold standard for combined cataract/glaucoma surgery remains phacoemulsification with trabeculectomy.
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References
Jampel H, Friedman DS, Lubomski LH, et al. Effect of technique on intraocular pressure after combined cataract and glaucoma surgery. Ophthalmology. 2002;109:2215–24.
Panchapakesan J, Mitchell P, Tumuluri K, Rochtchina E, Foran S, Cumming RG. Five year incidence of cataract surgery: the Blue Mountains Eye Study. Br J Ophthalmol. 2003;87(2):168–72.
Krupin T, Feitl ME, Bishop KI. Postoperative intraocular pressure rise in open-angle glaucoma patients after cataract or combined cataract-filtration surgery. Ophthalmology. 1989;96:579–84.
Levkovitch-Verbin H, Habot-Wilner Z, Burla N, et al. Intraocular pressure elevation within the first 24 hours after cataract surgery in patients with glaucoma or exfoliation syndrome. Ophthalmology. 2008;115:104–8.
Pohjalainen T, Vesti E, Uusitalo RJ, et al. Phacoemulsification and intraocular lens implantation in eyes with open-angle glaucoma. Acta Ophthalmol Scand. 2001;79:313–16.
Tham CC, Chan JC. The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle closure glaucoma (PACG) and coexisting cataract: a prospective case series. J Glaucoma. 2006;15(1):47–52.
Hayashi K, Hayashi H, Nakao F, et al. Effect of cataract surgery on intraocular pressure control in glaucoma patients. J Cataract Refract Surg. 2001;27(11):1779–86.
Vizerri G, Weinreb RN. Cataract surgery and glaucoma. Curr Opin Ophthalmol. 2010;21(1):20–4.
Husain R, Gazzard G, Aung T, et al. Initial management of acute primary angle closure: a randomized trial comparing phacoemulsification with laser peripheral iridotomy. Ophthalmology. 2012;119(11):2274–81.
Brown SV, Thomas JV, Budenz DL, Bellows AR, Simmons RJ. Effect of cataract surgery on intraocular pressure reduction obtained with laser trabeculoplasty. Am J Ophthalmol. 1985;100(3):373–6.
Tennen DG, Masket S. Short and long-term effect of clear corneal incision on intraocular pressure. J Cataract Refract Surg. 1996;22:568–70.
Tong JT, Miller KM. Intraocular pressure change after sutureless phacoemulsification and foldable posterior chamber lens implantation. J Cataract Refract Surg. 1998;24:256–62.
Shingleton BJ, Gamell LS, O’Donoghue MW. Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients. J Cataract Refract Surg. 1999;25:885–90.
Shingleton BJ, Pasternak JJ, Hung JW, et al. Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients. J Glaucoma. 2006;15:494–8.
Kass MA. Cataract extraction in an eye with filtering bleb. Ophthalmology. 1982;89:871–4.
Rebolleda G, Munoz-Negrete FJ. Phacoemulsification in eyes with functioning filtering blebs: a prospective study. Ophthalmology. 2002;109(12):2248–55.
Hopkins JJ, Apel A, Trope GE, et al. Early intraocular pressure after phacoemulsification combined with trabeculectomy. Ophthalmic Surg Lasers. 1998;29:273–9.
Cotran PR, Roh S, McGwin G. Randomized comparison of 1-site and 2-site phacotrabeculectomy with 3-year follow-up. Ophthalmology. 2008;115:447–54.
Weitzman M, Caprioli J. Temporal corneal phacoemulsification with separate-incision superior trabeculectomy. Ophthalmic Surg. 1995;26:271–3.
Fine IH, Hoffman RS, Packer M. Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography. J Cataract Refract Surg. 2007;33:94–7.
Bateman DN, Clark R, Azuara-Blanco A, et al. The effects of new topical treatments on management of glaucoma in Scotland: an examination of ophthalmological health care. Br J Ophthalmol. 2002;86:551–4.
Strutton DR, Walt JG. Trends in glaucoma surgery before and after the introduction of new topical glaucoma pharmacotherapies. J Glaucoma. 2004;13(3):221–6.
Damji KF, Shah KC, Rock WJ, et al. Selective laser trabeculoplasty v argon laser trabeculoplasty: a prospective randomised clinical trial. Br J Ophthalmol. 1999;83(6):718–22.
Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, et al. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye. 2004;18(5):498–502.
O’Brien TP. Emerging guidelines for use of NSAID therapy to optimize cataract surgery patient care. Curr Med Res Opin. 2005;21(7):1131–7.
Oetting TA, Omphroy LC. Modified technique using flexible iris retractors in clear corneal cataract surgery. J Cataract Refract Surg. 2002;28:596–8.
Akman A, Yilmaz G, Oto S, et al. Comparison of various pupil dilatation methods for phacoemulsification in eyes with a small pupil secondary to pseudoexfoliation. Ophthalmology. 2004;111:1693–8.
Miyake K, Ota I, Maekuba K, et al. Latanoprost accelerates disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema in early postoperative pseudophakias. Arch Ophthalmol. 1999;117:34–40.
Miyake K, Ota I, Ibaraki N, et al. Enhanced disruption of the blood–aqueous barrier and the incidence of angiographic cystoid macular edema by topical timolol and its preservative in early postoperative pseudophakia. Arch Ophthalmol. 2001;119:387–94.
Arcieri ES, Santana A, Rocha FN, et al. Blood-aqueous barrier changes after the use of prostaglandin analogues in patients pseudophakia or aphakia. Arch Ophthalmol. 2005;123:186–92.
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Zelefsky, J.R., Obstbaum, S.A. (2014). Cataract and Glaucoma Surgery. In: Samples, J., Schacknow, P. (eds) Clinical Glaucoma Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4172-4_30
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DOI: https://doi.org/10.1007/978-1-4614-4172-4_30
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