Cataract extraction alone may be beneficial in some glaucoma patients

KIAWAH ISLAND, S.C. — Cataract removal surgery may be a viable option for lowering IOP in some glaucoma patients.

Thomas W. Samuelson

"It's not going to cure [glaucoma] in the vast majority of cases that a consultative glaucoma surgeon is going to see, but it may be an incremental step," Thomas W. Samuelson, MD, said at Kiawah Eye 2009.

Recent studies have suggested that cataract surgery lowers IOP proportionally to preoperative IOP. Glaucoma patients with an IOP greater than 20 mm Hg who undergo cataract extraction may have their pressure lowered by as much as 20% to 30% postoperatively.

Based on those findings, Dr. Samuelson said, glaucoma surgeons may wish to view cataract surgery alone as part of the management strategy. Extraction should be considered in visually significant cataract or in the face of a bad refractive error, but the surgery should probably be performed before glaucoma surgery that bypasses the trabecular meshwork.

"Cataract surgery alone may be most the appropriate procedure for patients with modestly uncontrolled or controlled glaucoma," Dr. Samuelson said.

Certain cases may warrant combined phacotrabeculectomy, such as patients with a high risk of glaucoma progression, he said.

Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.