OPHTHALMOLOGY

Q: If I am a glaucoma patient, can I still have cataract surgery? Will I have good results?

A: For the glaucoma patient who also has cataracts, additional considerations are warranted since you are dealing with two separate conditions. First, a thorough, dilated eye exam should be performed to determine whether the cataract contributes significantly to the decreased visual acuity. Second, assess the glaucoma to determine if it is stable, mild, or advanced and how it is managed. Third, evaluate the condition of the optic nerve. And fourth, consider other factors that may affect the visual outcome such as any previous glaucoma surgeries or the presence of other eye diseases such as macular degeneration or diabetic retinopathy.

After assessment, if cataract surgery is necessary for the patient who also has glaucoma, there are various treatment options. Keep in mind that the first priority is to control the glaucoma. For patients with mild glaucoma, cataract surgery can be performed separately and the glaucoma managed with pressure-lowering drops or laser treatments. For patients with more serious glaucoma, a combination cataract removal and glaucoma surgery, such as a trabeculcetomy or the iStent Trabecular Micro-Bypass, can be performed. For the patient with both glaucoma and cataracts, it is important to understand and discuss with your eye surgeon all the factors involved along with the risks and benefits of the recommended treatment option. This includes the pros and cons of various surgical techniques, the skill and experience of the surgeon, expected visual outcome, post-operative care, plans for continued glaucoma management, and future monitoring of your overall eye health and vision. With the combined condition of glaucoma and cataracts, you will need to work closely with your eye surgeon to assess your particular needs to help reach the best possible visual outcome after cataract surgery.

Gregory Eippert, MD