Cataract Surgery in an Eye With a Functioning Filter
Small-incision cataract surgery can be performed in glaucomatous eyes without affecting the results of the previous filtering surgery. With a temporal corneal incision, the surgeon avoids the superior conjunctiva and the site in which filtering surgery was conducted. If conversion to an extracapsular technique is indicated (eg, in extreme phacodonesis with zonular instability or in capsular rupture with vitreous present in the AC), the surgeon may extend the clear corneal or scleral incision to permit removal of the crystalline lens. Closure of the temporal incision and creation of a larger corneoscleral incision superiorly can minimize astigmatism but also may compromise an existing filter. Aggressive control of postoperative inflammation is vital to ensure continued bleb function.
Francis BA, Singh K, Lin SC, et al. Novel glaucoma procedures: a report by the American Academy of Ophthalmology. Ophthalmology. 2011;118(7):1466–1480.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.