Cataract Surgery With Glaucoma: Is It Safe?

Primary causes of blindness worldwide, cataracts, and Glaucoma frequently coexist in elderly persons. The combination of both procedures may raise the likelihood of postoperative problems and jeopardise the success of either operation since glaucoma treatment might hasten the advancement of cataracts. 

However, cataract surgery has been shown to independently lower intraocular pressure (IOP), which may enable patients with coexisting cataracts and glaucoma to control their IOP better. It can be difficult to decide whether to have cataract surgery only or cataract surgery with glaucoma surgery together. 

To help doctors and get the best cataract surgery in glaucoma patients, it is crucial to compare the efficacy of these two approaches.

What is Cataract?

We all know that our eyes’ naturally clean lens aids in focusing light so we can see clearly. Also, you should be aware that the lens gets foggy as we age. Things appear fuzzy, drab, or less vibrant. The term we use for such situations is cataract. 

Many of us are further aware that a cataract can only be removed surgically. In other words, your doctor replaces the eye’s clouded natural lens with an artificial intraocular lens after removing the original lens (IOL).

What is Glaucoma?

Now, let’s see what is Glaucoma. So, Aqueous humour, the eye’s natural fluid, does not drain from the eye as easily when you have Glaucoma. The drainage angle, where fluid exits the eye, is blocked. The accumulation of fluid raises ocular pressure. This pressure damages your optic nerve.

How to treat cataracts in the eyes with Glaucoma?

The two eye conditions that are most common worldwide are cataracts and Glaucoma. As people age, both diseases become increasingly prevalent. Glaucoma is common among those who have cataracts. Your doctor may advise combined cataract-glaucoma surgery if a cataract makes it difficult to see clearly and your eye pressure is not where it should be despite medication or laser treatment.

Cataract And Glaucoma Combined Surgery

Your ophthalmologist will examine your eyes in order to determine the best course of treatment for you. They will examine the subsequent:

• How far has your Glaucoma progressed?
• Is the eye pressure decreasing through glaucoma medicine or laser surgery sufficient?
• Do cataracts interfere with your day-to-day activities?

Your ophthalmologist will recommend a course of treatment with the lowest risk and the best potential for improved vision. Your ophthalmologist will decide which sort of combined surgery to perform if having glaucoma surgery plus cataract surgery is appropriate for you.

• It is simpler for you: Comparing two procedures, one is more manageable and less traumatic.
• Less risk: Since anesthesia only needs to be administered once, the risks are cut in half.
• Reduce or stop using medications: If the glaucoma surgery is effective, you might be able to reduce or stop taking medicines for Glaucoma. The usage of eye drops is challenging for many people.
• Maintaining consistent ocular pressure after surgery: Sometimes, the pressure in the eyes increases suddenly after cataract surgery. Glaucoma surgery usually prevents this increase in ocular pressure from occurring.
• Less expensive: Combining two operations results in a lower cost. Additionally, you save money if the glaucoma surgery is successful because you won’t require as much or any glaucoma medication.

Who Should Not Go For Combined Surgery? 

Sometimes Glaucoma needs to be treated even though a cataract is not affecting vision. In these situations, it is advisable to perform the glaucoma surgery first and postpone the cataract surgery.

In some situations, Glaucoma is under good control without surgery, but cataracts impair vision. Cataract surgery with or without MIGS (Glaucoma controls with stents/implants) may be the best choice in these circumstances.

Other people suffer from narrow- or closed-angle Glaucoma in addition to cataracts, so they need to get cataract surgery for narrow angle glaucoma. The iris (the colored portion of the eye), which is pushed too far forward in this form of Glaucoma, prevents fluid from leaving the eye. This increases the eye pressure. This particular Glaucoma can deteriorate due to a cataract. Without glaucoma surgery, ocular pressure may decrease once the cataract is removed. When the bulky cataractous lens is removed, the narrow angle may open, improving glaucoma control.

Why CFS? 

Many of you may still be having trouble deciding if combination surgery is the best course of action for you. Of course, scheduling a consultation with a knowledgeable ophthalmic physician at CFS is the only way to be sure if this is the best course of action for you. We have a group of skilled and knowledgeable medical professionals who can offer you the best combined therapy for cataracts and Glaucoma.

Article: Cataract Surgery With Glaucoma: Is It Safe?
Author: CFS Editorial Team   |   July 05 2022 | UPDATED 11:30 IST

*The views expressed here are solely those of the author in his private capacity and do not in any way represent the views of Centre for Sight. ‘