Extracapsular cataract extraction with intraocular lens implantation after glaucoma surgery

PURPOSE: To analyse results of cataract surgery with intraocular lens implantation in eyes with previous glaucoma surgery. MATERIAL AND METHODS: In the years 1994-1996 in 44 eyes of 39 patients (13 males and 26 females) cataract surgery was performed. The follow-up ranged from 3 to 12 months (mean 8.5 months). The time interval between glaucoma surgery and cataract surgery ranged from 1 month to 40 years. The most frequent kind of glaucoma surgery was trabeculectomy (77.3%). An inverse corneal incision and envelope capsulotomy was performed in every eye, thirty eight percent required synechiolysis and twenty percent iridoplastic surgery. RESULTS: Intraoperatively there were 2 cases of posterior capsule tears with vitreous loss and 4 mild hemorrhages into anterior chamber. The most common postoperative complications were Descemet's membrane folds (36.4%), fibrinous exudate in anterior chamber (27.3%) and transient corneal oedema (9.2%). Fifty percent of eyes achieved the best corrected visual acuity-5/8 and better. Postoperative astigmatism mostly with the rule was observed in 86.4% eyes. Postoperative intraocular pressure was unchanged in 81.8% eyes, and in 13.8 percent of eyes preoperative glaucoma medication was no longer required. CONCLUSIONS: The technique of extracapsular cataract extraction with intraocular lens implantation is a safe procedure giving good visual rehabilitation and having no influence on glaucoma control in patients who had previous glaucoma surgery.