Will cataract surgery affect my glaucoma?

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The ophthalmologist tailors the specific treatment plan for the individual eye to maximize the benefits and minimize the risk to the eye. The ophthalmologist balances many factors that affect the decision as to when and how aggressively the glaucoma and cataract should be treated, including whether the two diseases should be treated at the same time or separately.

There are a number of options available to glaucoma patients with cataracts, and each situation must be assessed individually. If the cataract does not interfere with the glaucoma patient’s activities significantly then treating the glaucoma and monitoring cataract
progression—but not removing the cataract immediately—may be an appropriate plan. Often, the glaucoma can be managed with laser treatment and anti-glaucoma medications. When this is possible, it allows the ophthalmologist to monitor the eye while the cataract worsens.

Here is more information on cataract surgery and glaucoma

Posted on October 16, 2008 4:46 PM

Comments (3)

My Ophthalmologist has recommended doing cataract surgery for a phacomorphic angle closure glaucoma in my right eye. The condition has also been referred to as plateau iris. Although there is a very small cataract on this eye it is not the reason for the surgery. Is there anything in the literature that supports this type of procedure for someone with my condition? Gonioplasty was mentioned but I was told that a permanent enlargement of my pupil was a common result of this procedure.

Thank you in advance for any information you have about this type of surgery for this type of conditon.

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Response from Glaucoma Research Foundation:

The crystalline lens has a pivotal role in primary angle closure (PAC), both in the pathogenesis of pupil block and by exacerbating the effect of non-pupil block mechanisms such as peripheral iris crowding. Eyes with angle closure tend to have shallow anterior chambers and thick, anteriorly positioned lenses when compared with normal eyes. Removing the lens creates more space in the anterior chamber and widens the angle, which may be enough to achieve intraocular pressure (IOP) control. The role of lens extraction as a treatment for angle closure has been debated for many years.

Here are links to journal articles that are relevant to your situation:

"Lens extraction for uncontrolled angle-closure glaucoma: long-term follow-up": http://www.ncbi.nlm.nih.gov/pubmed/9795850.

"Lens extraction for uncontrolled angle-closure glaucoma: long-term follow-up": http://www.ncbi.nlm.nih.gov/pubmed/9795850

"Preliminary outcomes of primary phacoemulsification plus intraocular lens implantation for primary angle-closure glaucoma": http://www.jstage.jst.go.jp/article/jmi/55/3,4/287/_pdf

"Effect of lens extraction on primary angle closure in a Thai population": http://www.ncbi.nlm.nih.gov/pubmed/18575281

"The lens and angle-closure glaucoma": http://www.ascrs.org/publications/jcrs/editjul00.htm

Posted by Alice N. Duehl | December 7, 2008 6:36 PM

is there is any problem regarding laser treatment for glaucoma

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Response from the Glaucoma Research Foundation:

Glaucoma laser surgeries help to lower the intraocular pressure (IOP) in the eye. The length of time the IOP is lowered will depend on the type of laser surgery, the type of glaucoma, age, race, and many other factors. Some people may need the surgery repeated to get better control of the IOP, depending on the type of laser surgery done. In most cases, medications will still be necessary to control and maintain eye pressure. However, surgery may lessen the amount of medication needed.
Here is more information on "laser surgery": http://www.glaucoma.org/treating/surgery.php?section=152

Posted by durga | December 25, 2008 6:40 AM

What is the best way to resolve the issue of scar tissue after surgery for a shunt?

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Response from the Glaucoma Research Foundation:

Approximately 15% of the shunt procedures have had to be revised if the buildup of scar tissue is too thick for the fluid in the eye to pass through. This is a fairly simple procedure and not at all like the original procedure. A small incision is made over the plate and the scar tissue removed. The incision is then sewn up.

Posted by Margaret Shaleuly | March 13, 2009 7:16 AM