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Cataract surgery first leads to better long-term maintenance of glaucoma
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NEW YORK — Planning cataract surgery before glaucoma surgery leads to better long-term maintenance of glaucoma, according to a speaker here.
In patients with narrow open-angle glaucoma with high IOP, cataract surgery deepens the angle, increases the anterior chamber, prevents peripheral anterior synechiae (PAS) and decreases IOP, Savak Teymoorian, MD, said at OSN New York 2014.
Savak Teymoorian
“This [cataract surgery] allows you to open up the trabecular meshwork, help bring the pressure down, prevent the creation of PAS and help eliminate the need for possible surgical intervention in the future,” Teymoorian said.
The earlier the glaucoma treatment, the better for the patient, Teymoorian said.
“If you decrease those PAS formations now, there will be a much better outcome in the future,” Teymoorian said.
Cataract surgery can have complications if prior glaucoma surgery was performed on the patient, such as difficulty with measurements and scarring from previous surgery.
“There is nothing more depressing than doing a good glaucoma surgery that works but the patient says, ‘I cannot see well because of my cataract.’ Up to 50% of people within 1 to 2 years will develop the cataract,” Teymoorian said.
According to Teymoorian, 75% of glaucoma surgeries that were functional will no longer be functional within 2 years because of cataract.
To avoid these complications, surgeons should perform cataract surgery before glaucoma surgery.
“Even if you do have to refer to a glaucoma surgeon, the glaucoma surgery is significantly easier to do when the cataract is already removed,” Teymoorian said.
Disclosure: Teymoorian is on the medical advisory board for Allergan and does research for Bausch + Lomb.