by Vanessa Caceres EyeWorld Contributing Writer
A
s more glaucoma surgeons
consider cataract surgery
as a treatment option for
their patients to lower
IOP, they also must think
about which patients will benefit
most from the procedure. Presenters
at the Sunday morning symposium
"Controversies in Cataract and
Glaucoma," sponsored by the ASCRS
Glaucoma Clinical Committee,
focused on this topic.
Leon Herndon, MD, Durham,
N.C., and Nathan Radcliffe, MD,
New York, moderated the session.
To start things off, Thomas
Samuelson, MD, Minneapolis,
said that cataract surgery is a viable
primary procedure for primary
open-angle glaucoma (POAG). He
shared data on the IOP-lowering
potential of phacoemulsification for
other glaucoma types but raised the
question of whether the lens plays
a causal role in adult onset phakic
POAG. "When the system is dys-
functional, taking out the cataract
appears to help," he said.
Another consideration is the
role of cataract surgery for primary
angle closure glaucoma (PACG),
said George Tanaka, MD, San
Francisco. Although the benefit of
the procedure in an acute setting
is shown, the choice is murkier in
patients without cataracts, he said.
The best approach likely depends
on whether the patient is a primary
angle closure suspect or has PACG.
Cataract surgery without a laser
peripheral iridotomy is reasonable
for a primary angle closure suspect;
for PACG, cataract surgery instead
of or in combination with a trabe-
culectomy are solid choices, he said.
Glaucoma surgeons also are awaiting
the results of the EAGLE trial, which
focuses on early lens extraction for
the treatment of PACG.
With all eyes in ophthalmolo-
gy on femtosecond laser refractive
cataract surgery, Eric Donnenfeld,
MD, Rockville Centre, N.Y., shared
possible benefits of the newer tech-
nology for glaucoma patients. This
can include improved architecture
Considering cataract
surgery for glaucoma
patients
Dr. Crandall addresses attendees at Sunday's symposium "Controversies in Cataract and
Glaucoma."
