At times, combined surgery, cataract surgery and glaucoma surgery, may be combined to be performed at the same time. Not everyone with cataracts and not everyone with glaucoma needs simultaneous eye surgery, but your doctor may recommend this at some point.
Patients with both cataracts and glaucoma can have combined surgery to address both conditions at the same time. To determine if a combined cataract/glaucoma surgery is right for you consider these three things:
- How advanced is your glaucoma?
- Is your current glaucoma therapy/medications lowering your eye pressure enough?
- Are your cataracts affecting your daily activities?
The following are the reasons your ophthalmologist may suggest combined surgery:
- Less risk: If you have anesthesia one time, the risk of issues is less.
- Stop medication: If you are finding it hard to use the medication or having side effects, glaucoma surgery may enable you to stop taking the glaucoma medications.
- Stabilize eye pressure: Sometimes after cataract surgery there is a sudden rise in eye pressure. If you have glaucoma and combine your cataract surgery with a glaucoma surgery, that rise in eye pressure usually does not happen.
- Lower cost: Having two surgeries combined at one time is less expensive. And a successful glaucoma surgery may save you money because you won’t need glaucoma medications.
The three common types of glaucoma surgery:
This surgery creates a new pathway to drain fluid from the inside of the eye. To create this new pathway a tiny piece of the wall of the eye is removed to open a new drain. This drain is a bypass for the former drainage area, the trabecular meshwork.
Eye pressure is reduced because fluid can now drain with relative ease through the new opening into a reservoir underneath the conjunctiva. The fluid is then absorbed by the body.
A tiny plastic tube called a shunt is inserted under the clear membrane covering of the sclera (white part of the eye). The shunt drains the blocked fluid to a plastic plate inserted on the eye wall. The drained fluid is absorbed by nearby blood vessels.
Microinvasive Glaucoma Surgery
This procedure uses the same incision created for your cataract surgery and the blocked fluid is drained with a small tube or stent. These surgeries lower eye pressure, but no enough to stop all glaucoma medications.
When Combined Surgery is Not Advised
When the cataract is not causing any vision problems, but the glaucoma needs to be surgically treated.
When the glaucoma is well-controlled without surgery, cataracts are limiting vision.
When patients have narrow-angle glaucoma in which the iris is pushed too far forward and is blocking the flow of fluid from the eye. A cataract can make this type of glaucoma worse and removing the cataract may improve the eye pressure without glaucoma surgery.