Cataracts and Glaucoma Treatment
What If You Have Both Cataracts And Glaucoma?
Not that long ago, patients with both cataracts and glaucoma had a difficult decision to make. They could:
- Have cataract surgery alone but risk having a post-operative “IOP spike” that could result in a loss of vision.
- Have a “combined” procedure (cataract surgery plus a trabeculectomy or tube shunt). The problem with this option is that the “trab” often “failed” when both procedures were done together. Indeed, a trabeculectomy performed at the same time as cataract surgery is sometimes called an “orphan trabeculectomy” because it is expected that it will essentially have to be given up.
- Perform a “staged” procedure where both cataract surgery and trabeculectomy were done, but at separate times. There are two options to stage, both with problems:
- Cataract surgery first, trabeculectomy second. As mentioned above, having cataract surgery alone risks a post-op IOP spike. If this happens, the eye is at risk of loss of vision until the trabeculecomy is performed. If a trab is done too soon, the residual inflammation from cataract surgery can risk “bleb failure.”
- Trabeculectomy first, cataract surgery second. Although the presence of a bleb at the time of cataract surgery would effectively protect against an IOP spike, the long-term risk of staging in this manner is that the bleb often fails after cataract surgery is performed.
As you can see, none of these options are ideal. Fortunately, with the advent of Canaloplasty, patients with both cataract and glaucoma can expect both improved vision and reduced pressure when PhacoCanaloplasty is chosen.
Because Canaloplasty does not require a bleb it is not at risk of failure after cataract surgery. Indeed, the three year results of combined PhacoCanaloplasty were published in April 2011 and impressively showed that patients who had the combined procedure did better than those who had Canaloplasty alone.
Canaloplasty Explainer Video
As with any surgery, it is important to discuss the risks and benefits of combined cataract and Canaloplasty surgery with your eye surgeon to determine what is the most appropriate treatment for you.