Extracapsular cataract extraction and posterior chamber lens implantation in eyes with preexisting glaucoma
L. J. McGuigan, J. Gottsch, W. J. Stark, A. E. Maumenee and H. A. Quigley
Fifty eyes of 40 patients with glaucoma underwent extracapsular cataract
extraction with posterior chamber lens implantation. Their visual results
and early postoperative complications were compared with those of eyes in
an age-matched group of patients without glaucoma after the same procedure.
Substantial increases in early postoperative intraocular pressure (IOP)
occurred in 62% of the glaucomatous eyes and in only 10% of the normal
eyes. The level of best visual acuity was slightly worse (20/40) on average
in the glaucomatous eyes than in the nonglaucomatous eyes (20/25). At six
months after surgery, 82.5% of the nonfiltered glaucomatous eyes needed the
same number of or additional glaucoma medications to maintain an IOP of
less than 20 mm Hg. Ten of the glaucomatous eyes underwent trabeculectomy
along with cataract surgery due to inadequate IOP control while the patient
was receiving maximum medical therapy. Control was substantially improved,
with 100% of these patients receiving the same number of or fewer
medications at six months. By one year, only 30% of these patients required
the same number of medications postoperatively as preoperatively, but all
had IOP control.
