Concomitant phacoemulsification and glaucoma surgery is a viable treatment option for glaucoma patients who have coexisting cataract, with lowered pressure and reduced medications resulting from combined cataract surgery and glaucoma procedures.
“It’s important to realize that there are multiple options that can be combined with cataract surgery to manage glaucoma,†Bradford J. Shingleton, MD, said. “It can be a trabeculectomy, with or without mitomycin, it can be an Ex-PRESS (Alcon) shunt, with or without mitomycin, it can be canaloplasty (iScience Interventional), endoscopic cyclophotocoagulation, tube shunts, Trabectome (NeoMedix), and then there are some internal stents being developed, as well as some suprachoroidal shunts. Our armamentarium is expanding greatly as to what can be done supplemental to cataract surgery at the time of operation.†Phaco alone or glaucoma surgery followed by a separate phaco procedure are also treatment options, he said. He emphasized that surgical selection for glaucoma patients with coexisting cataract should be based on each patient’s case, including stage of glaucoma and visual significance of cataract.