Long-term effect of cataract extraction on the function of an established filtering bleb.

BACKGROUND AND OBJECTIVE

For patients with advanced glaucoma, care must be taken in the management of cataract to prevent loss of long-term intraocular pressure (IOP) control. The authors evaluated the effect of extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implantation via the inferotemporal limbal approach on the function of an established glaucoma filtering bleb.

PATIENTS AND METHODS

Twenty-three eyes of 21 patients with a minimum of 48 months of follow-up (range 48 to 97 months) were retrospectively evaluated. IOP, bleb status, visual field, and visual acuity were compared before and after operation.

RESULTS

Average IOP increased from 8.7 mm Hg preoperatively to 12.2 mm Hg at last follow-up. Six blebs (26.1%) decreased in size, 11 (47.8%) did not change, 4 (17.4%) increased in size, and 2 (8.7%) were lost and required refiltration. At last follow-up, 23 eyes had an IOP of less than 20 mm Hg and did not show progression of glaucoma damage by optic disc or visual field evaluation. Six eyes required resumption of medical therapy and 2 eyes required refiltration for adequate control.

CONCLUSION

ECCE with PC IOL implantation via the inferotemporal limbal approach in the presence of an established filtering bleb is effective in the long-term management of the glaucomatous eye with cataract.