Cataract surgery and glaucoma.

PURPOSE OF REVIEW: To summarize the recent advances in the management of patients with coexisting cataract and glaucoma.

RECENT FINDINGS: Although some evidence suggests that cataract surgery may be useful in the clinical management of eyes with angle closure glaucoma, recent studies show that the decrease in intraocular pressure (IOP) following cataract surgery alone in eyes with open angle glaucoma may be limited and transient. Combining cataract surgery with a trabeculectomy remains the preferred option. However, when IOP lowering is indicated, newer surgical techniques to lower IOP to be performed along with cataract extraction offer a promising alternative in patients with uncontrolled glaucoma and a visually significant cataract.

SUMMARY: Cataract surgery alone or combined with trabeculectomy should be considered in the treatment of angle closure glaucoma. However, in eyes with open angle glaucoma, cataract surgery alone may be of limited clinical benefit in lowering IOP. Surgical alternatives to be combined with cataract extraction may be utilized to achieve a more significant IOP reduction. The appropriate treatment should be tailored based on patient's characteristics and the target IOP to be achieved.