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Surgeon chooses cataract surgery first for glaucoma cases
ORLANDO, Fla. — Cataract surgery is a good operation for open-angle glaucoma, and it is a great operation in angle-closure glaucoma, a speaker said here.
Taking that line of thinking further, Reay H. Brown, MD, told colleagues at the annual meeting of the American Academy of Ophthalmology, "If you look at it from a risk-benefit standpoint, it is the best glaucoma operation."
Cataract surgery improves vision, has low rates of complication and low rates of reoperation, he said.
There are times, however, when cataract surgery is not an option as treatment for glaucoma, Dr. Brown said. For example, he warned against performing cataract surgery in patients with open-angle glaucoma who have an IOP greater than 30 mm Hg, or in patients with long-standing angle-closure glaucoma whose IOP is unpredictable. The greater the IOP, the greater the risk of high IOP postoperatively, he said.
"The bottom line is, cataract surgery is not a trabeculectomy," he said.
Dr. Brown said he would perform cataract surgery in most cases in patients older than 50 years with open-angle glaucoma and an IOP of less than 30 mm Hg and in most patients with angle-closure glaucoma of any age and any IOP measurement.
- Disclosure: Dr. Brown is a consultant for Allergan and Ivantis, and has financial interest in Rhein Medical.