Approach to Cataract Surgery in Glaucoma Patients

Cataract surgery in glaucoma patients requires specific planning to achieve optimal outcomes for the patient and surgeon. Visual loss from the cataract must be differentiated from the glaucoma, so expectations can be realistic. Aims of the surgery must be clearly defined in terms of vision and intraocular pressure control. Careful preoperative evaluation will account for any nuances of pathophysiology likely to be encountered intraoperatively and potential complications avoided postoperatively. The surgical approach of cataract surgery alone versus combined cataract/glaucoma surgery will be determined by the type and severity of the pathologies. Technology in this area is evolving with numerous microinvasive glaucoma surgical devices available, many able to be used in conjunction with phacoemulsification. Ultimately, the degree of intraocular pressure control is determined by the rate of visual progression and management tailored to the individual patient.