Often, glaucoma patients can have cataracts as well. Whether or not cataract surgery and glaucoma can be treated when the conditions coincide with one another depends on a number of factors. Cataracts are often considered to be a normal aspect of the aging process that causes a clouding of the lens in the eye. When this occurs, vision becomes poor as the lens can no longer focus on objects clearly. A cataract progresses over time and isn’t generally considered an urgent problem. Luckily, there are treatment options available to treat this condition. However, if glaucoma is present as well, cataract surgery may not be an option.
Glaucoma is another eye condition that can threaten vision. This condition eventually causes optic nerve damage as a result of increased pressure in the eye. Glaucoma is the second leading cause of blindness in the United States. Depending on which of the four types of glaucoma is present, medications or surgery is needed for treatment to reduce the pressure. Unfortunately, optic nerve damage is permanent.
Cataract Surgery and Glaucoma
Before cataract surgery can be considered in glaucoma patients, the risks of treatment must be evaluated. In order to come to a decision, an ophthalmologist will consider which condition requires treatment first and whether or not the conditions should be treated together or separately. The risks of each treatment will also be weighed carefully prior to making a decision.
When evaluating how the glaucoma will be affected by cataract surgery, the amount of vision loss and optic nerve damage that may occur will be examined carefully. A glaucoma patient’s medications, and prior eye surgeries are also used to decide whether or not cataract surgery is an option. The eye pressure prior to surgery is evaluated as well as the patient’s tolerance for certain glaucoma medications.
In patients who are able to undergo cataract surgery with glaucoma, possible benefits include increased central vision and increased ability to control peripheral vision by lowering the pressure within the eye, benefiting both conditions. Cataract is generally resolved after surgery and eye pressure control is more likely to remain stable, possibly eliminating the need for further glaucoma medications.
There are many risks that can occur if cataract surgery is performed when glaucoma is present. These possible risks include infected or leaky blebs, low eye pressure and bleeding. Other risks involved include retina and choroid swelling and surgery complications.
When deciding whether or not cataract surgery and glaucoma is an option, the benefits and risks must be weighed carefully. While cataract surgery is very beneficial, especially when glaucoma surgery is performed as well, the benefits can be substantial. But the risk involved can be just as substantial. The decision whether or not to perform cataract surgery depends on the facts associated with each individual case.
"Glaucoma" PubMedHealth. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002587/
"Catartact Surgery and the Glaucoma Patient" WillGlaucoma.org. https://www.willsglaucoma.org/educat.htm
"Cataract Surgery and Glaucoma" Glaucoma.org. https://www.glaucoma.org/treating/cataract_surger.php