Treating Cataracts & Glaucoma

Cataracts are treated with surgery to remove them, and at the same operation they are replaced by lens implants made of a special acrylic material. The opaque lens will be replaced with a clear silicone implant that will remove the cataract and reduce dependency on glasses. Good vision requires a transparent lens in the eye. This causes a gradual loss in peripheral vision. Vitreous loss may lead to failure of glaucoma surgery. Untreated glaucoma will eventually lead to total vision loss. The doctor will choose a lens power that will properly focus your vision. Depending on the type of glaucoma, the supporting lens structures may be weakened. A cataract may involve just a tiny area in the lens and stay small, or it may occupy the entire lens, leading to partial or complete vision loss. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.

Cataract surgery is suggested when a person’s vision has declined to the point where it interferes with their usual daily tasks. How will cataract surgery affect the glaucoma? Modern cataract surgery has very few risks, and can greatly improve you quality of life. If a patient has central island from severe glaucoma, cataract surgery may not be beneficial in terms of visual outcome. When vision is impaired to the point that it interferes with a person’s daily activities, surgery may be considered. Often the vision may be improved by looking through a pinhole. Cataracts may naturally coexist with glaucoma, have a causative effect on glaucoma, and/or may even be a result of glaucoma surgery. Overall, the quality of the evidence was very low to low due to differences in study characteristics (e.g., type of glaucoma surgery) and poor reporting of outcomes from included studies. However, due to differences in the effects among the individual studies and potential for bias in the study results, this conclusion is not definitive. Still, there are potential side effects with any procedure, and LASIK also has its limitations especially for those with very high spectacle degrees.

If patients have severe glaucoma, affecting the central vision, there is a risk that any surgical intervention may cause the remaining nerve fibres to die ("snuff out"). According to the “Glaucoma study” there are almost 4 million people in US who are suffering from glaucoma but cataract is affecting 22 million US people. Similar to the ones encountered with cataract surgery alone or trabeculectomy alone. It is equally important to note that modern clear corneal temporal phacoemulsification leaves the superior conjunctiva untouched for future trabeculectomy and tube implantation. Attention is then turned to the superior conjunctiva. The basic surgical technique involves placement of the plate in one of the superior quadrants approximately 8 mm from the limbus, preferrably the superotemporal quadrant to avoid compression on the optic nerve, with the tube placement in the anterior chamber. Cycloplegics may be used in cases of shallow anterior chamber or hypotony. Because angle-closure glaucoma is an emergency and pressure needs to be reduced quickly, you may need to have the fluid drained intravenously.

If you are suffering from primary open angle glaucoma, you may be given eye drops to decrease the pressure in your eyes. Over time this can be damaging to your eyes. In patients presenting with both cataracts and uncontrolled glaucoma, any of these devices can be placed at the time of cataract surgery. Eye pressure spikes after cataract surgery may be more common in patients with underlying glaucoma and importantly, glaucoma patients are more likely to be susceptible to damage from a transient increase in eye pressure. Often these pressure spikes are short-term and can be treated with medicines. Once the cataracts or one cataract is removed, people are able to appreciate the visual decline that the cataract had caused. Unlike vision loss from glaucoma, cataract vision loss can often be regained. When opacities develop in the lens, vision will less clear. Can surgery restore vision loss from a cataract?

Cataract surgery alone is sufficient for patients with well controlled IOP in the setting of early to moderate optic nerve damage. This decision is difficult to make because glaucoma surgery can accelerate cataract progression, cataract surgery can lower IOP independently, and performing both surgeries may increase the rate of complications. Any and all of these manoeuvres lengthen the operation and make it a little more risky. This can be a result of chronic use of miotics, chronic inflammation leading to synechiae formation, chronic angle closure, prior trauma, or prior laser procedures. How can I prevent cataracts, or can I slow down their progression? However, not everyone can get this surgery. The most important treatment for glaucoma is early detection and treatment. Surgical strategies for coexisting glaucoma and cataract: an evidence-based update. After grappling with a diagnosis of glaucoma, understanding the aims and choices of treatment, you have been told that you have cataracts. In this form of glaucoma, pressure in the eye rises quickly to very high levels. When fluid is prevented from flowing out, the intraocular pressure increases and damages the optic nerve.