Monday, August 31, 2009

Combined Glaucoma & Cataract Treatment: Dilemma in management

What if a person has both Cataract & Glaucoma?
Co-existence of glaucoma & cataract pose difficulty in management of either. There is always a dilemma whether to operate them together or one at a time.

As a general principle, in cases of patient with both Cataract & Glaucoma it is desirable to control glaucoma first and then proceed for cataract surgery. If the pressure / glaucoma control is easily achieved by 1-2 drugs then one can go for cataract surgery without worrying about glaucoma. In cases of advanced glaucoma or when the pressure requires more than 2-3 drugs for control then one may have to consider glaucoma surgery. Although it is possible to do both glaucoma & cataract surgery together at the same time, however, the results may be slightly compromised. It is ideal to do glaucoma surgery first and cataract surgery later, if the clinical condition of the eye & the patient permits.

Only in advanced glaucoma & advanced cataract with impending complications, is it justified to proceed with Combined Cataract & Glaucoma Surgery also called Phaco-Trab or Phacotrabeculectomy.

Dr. Sanjay Dhawan
Senior Eye Surgeon
New Delhi & Gurgaon

More about Cataract and Glaucoma

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