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Abstract #49338 Published in IGR 14-1
Management of concomitant cataract and glaucoma
Marchini G; Ceruti P; Vizzari GDevelopments in Ophthalmology 2012; 50: 146-156
The coexistence and management of cataract and glaucoma represents a challenging and unsolved problem. The surgical management of this problem is based on both visual field defect and loss of visual acuity. The surgical options currently available are: (1) cataract extraction alone; (2) cataract extraction followed by glaucoma surgery; (3) glaucoma surgery and afterwards, if necessary, cataract extraction; (4) combined surgery of cataract and glaucoma by one site or by two separate sites. Phacoemulsification alone is suggested when glaucoma can be sufficiently controlled by medication and visual field defect is moderate and not progressive. When glaucoma needs three or more types of medication to reduce intraocular pressure (IOP) or when the offset is unpredictable, phacoemulsification associated with glaucoma surgery at two different times allows a higher IOP reduction than that with a cataract extraction alone. Finally, when glaucoma is prevailing and the surgeon fears that an IOP spike after phacoemulsification may cause significant damage to the optic nerve, combined surgery allows to achieve a greater IOP decrease than phacoemulsification alone and a more predictable low-IOP range in the immediate postoperative period.
Eye Clinic, Department of Neurological and Visual Sciences, University of Verona, Verona, Italy.
Full articleClassification:
9.4.4.2 Glaucomas associated with cataracts (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
12.1 General management, indication (Part of: 12 Surgical treatment)
