2020–2021 BCSC Basic and Clinical Science Course™
Chapter 13: Surgical Therapy for Glaucoma
Cataract Surgery in the Glaucoma Patient
Primary Open-Angle Glaucoma
Many retrospective and prospective studies have shown that cataract surgery reduces IOP in patients with OAG. This reduction is thought to be the result of increased outflow facility. Hypothesized mechanisms for this effect include the following:
A meta-analysis found a mean IOP reduction of 3 mm Hg after cataract surgery in eyes with POAG, although the decrease in IOP seems to dissipate over time. However, in some patients, cataract surgery can be associated with acute and persistent IOP elevation. There is no evidence to support removal of cataracts that are not visually significant in the management of OAG.
Chen PP, Lin SC, Junk AK, Radhakrishnan S, Singh K, Chen TC. The effect of phacoemulsification on intraocular pressure in glaucoma patients: a report by the American Academy of Ophthalmology. Ophthalmology. 2015:122(7):1294–1307.
Masis M, Mineault PJ, Phan E, Lin SC. The role of phacoemulsification in glaucoma therapy: a systematic review and meta-analysis. Surv Ophthalmol. 2018;63(5):700–710.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.