Cataract Extraction after Glaucoma Surgery

Objective: To assess the safety and efficacy of extracapsular cataract extraction with intraocular lens (IOL) implantation in eyes with previous glaucoma surgery (PGS). Study Design: Retrospective analysis of results of all patients with PGS undergoing cataract extraction with a minimum follow-up of 7 months. Setting: Ophthalmic Department, North Riding Infirmary, Middlesbrough. Patients: Eighty-three eyes with PGS undergoing extracapsular cataract extraction. Main Outcome Measures: Best corrected visual acuity, postoperative intraocular pressure (IOP) and glaucoma control, incidence of operative and post-operative complications. Results: Seventy-two percent of eyes achieved a visual acuity of 6/12 or better. Seven percent of eyes required additional glaucoma medical treatment from the first 3 months and 4% required further glaucoma surgery within the first 12 months. Significant postoperative complications occurred in 5 eyes. Conclusions: In patients with PGS, clear corneal extracapsular cataract extraction with IOL implantation with iridoplastic surgery if required provides a safe and effective procedure for visual rehabilitation although the visual results are not as good as in a general cataract series. Such patients should be kept under close review over the first 12 months after cataract surgery because of a small incidence of loss of glaucoma control.