Surgery for glaucoma and a cataract

Cataracts may occur in people who also have glaucoma; this commonly occurs in older people.

If you have glaucoma and cataracts, you may consider having surgery for both conditions at the same time. Depending on which condition caused the vision loss, you may have improved vision after surgery.

• If the vision loss before surgery was mostly caused by the cataract, you may have noticeable improvement in your vision. Also, surgery may delay the progression of vision loss caused by glaucoma.
• If the vision loss before surgery was mostly caused by glaucoma, rather than the cataract, you may not have much improvement in vision after surgery. However, surgery may slow the loss of vision caused by glaucoma.

People whose glaucoma is controlled by using one medication and who need cataract surgery usually have cataract surgery only. Cataract surgery alone is quicker and less complicated than having both surgeries at the same time.

A review by the U.S. Agency for Healthcare Research and Quality (AHRQ) found that glaucoma surgery is associated with an increased risk of cataracts developing after the surgery.¹ In many cases where glaucoma and cataract occur together, surgery to treat both conditions may be done at the same time. The AHRQ review found that:

• Combining glaucoma surgery with cataract surgery lowers the pressure inside the eye (intraocular pressure, or IOP), which is a factor in many cases of glaucoma, more than cataract surgery alone; however, evidence indicates that glaucoma surgery alone is more effective at lowering IOP than the combined surgery.
• The same complications may occur with the combined surgery as occur with either glaucoma or cataract surgery alone.

If you have both glaucoma and cataracts, talk with your doctor about the benefits and risks of combined surgery to treat both conditions.

Citations

1. Agency for Healthcare Quality and Research (2001). Surgical Treatment of Coexisting Cataract and Glaucoma. Summary. Evidence Report/Technology Assessment No. 38 (AHRQ Publication No. 01-E049). Rockville, MD: Agency for Healthcare Quality and Research. Also available online: http://www.ahrq.gov/clinic/epcsums/catarsum.htm.