Document Detail

Incidence and management of cataract after glaucoma surgery.
MedLine Citation:
PMID:  23222149     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: This review summarizes the recent literature regarding the incidence and management of cataract following glaucoma surgery.
RECENT FINDINGS: Half of the total number of phakic patients that have either trabeculectomy or tube shunt surgery will go on to develop visually significant cataract within 5 years. Phacoemulsification following trabeculectomy is significantly associated with bleb failure and loss of intraocular pressure (IOP) control. Recent studies suggest that the risk of bleb failure increases, the earlier cataract surgery is performed, and recommend a delay of at least 1-2 years after trabeculectomy to enable the bleb to stabilize. Bleb failure occurs because of scarring secondary to postoperative inflammation. Evidence suggests that intraoperative subconjunctival 5-fluorouracil (5-FU) may be protective, and repeated postoperative 5-FU injections may have a role in high-risk individuals along with aggressive anti-inflammatory treatment. Phacoemulsification following tube shunt surgery improves vision and does not affect IOP control. Novel glaucoma procedures are emerging, but they are often combined with cataract surgery, and/or clinical studies are at an early stage.
SUMMARY: The development of visually significant cataract is common after glaucoma surgery. Subsequent cataract surgery can affect IOP control following trabeculectomy but not after tube shunt surgery. Measures to minimize the risk of bleb failure and loss of IOP control following trabeculectomy are critical in the management approach to patients who have had trabeculectomy.
Hussain Y Patel; Helen V Danesh-Meyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in ophthalmology     Volume:  24     ISSN:  1531-7021     ISO Abbreviation:  Curr Opin Ophthalmol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011108     Medline TA:  Curr Opin Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  15-20     Citation Subset:  IM    
Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
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