OPHTHALMOLOGY

Q: Does cataract surgery lower intraocular pressure? Since I have both cataracts and glaucoma, how would cataract surgery affect my glaucoma? A:

Cataracts and glaucoma are the first and second leading causes of blindness worldwide and these two eye conditions often occur simultaneously. Elevated intraocular pressure, IOP, is a risk factor for those with glaucoma and lowering/ controlling IOP is a primary goal in treating glaucoma. Cataract surgery is suggested when a person’s vision has declined to the point where it interferes with their usual daily tasks. Studies show that modern cataract surgery may lower IOP. This is especially beneficial in glaucoma patients and may allow for better pressure control following the surgery. Additionally, studies show that, on average, a lower IOP may continue a few years after cataract surgery.

While glaucoma patients may benefit from a lower IOP after cataract surgery, the effects vary between individuals. Before proceeding with cataract surgery when you also have glaucoma, make sure to discuss and understand all the factors involved including the risks and benefits. 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.

If cataract surgery is necessary for the patient who 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 trabeculectomy, or the iStent Trabecular Micro-Bypass, can be performed.

The benefits of cataract surgery for those with glaucoma may include increased visual acuity and improved contrast sensitivity due to the clear artificial lens. These improvements in vision, along with a clearer optical pathway no longer blocked by a cataract, gives your eye doctor a better view of the optic nerve. These factors combined can lead to more accurate visual field testing, enhanced optic nerve imaging, and help to facilitate glaucoma care management after cataract surgery.

With the combined condition of glaucoma and cataracts, you will need to work closely with your eye doctor and eye surgeon to assess your particular needs and help reach the best possible visual outcome after cataract surgery. After surgery, it is also important to continue seeing your eye doctor as frequently as recommended for IOP checks, testing, and dilated exams to help maintain the health of your eyes. Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com