[Cataract surgery in patients with end-stage glaucoma].
BACKGROUND
The purpose of this study was to assess the benefit of cataract surgery in patients with advanced cataract and glaucoma.


METHODS
In a prospective study, we investigated 12 consecutive patients (12 eyes). Inclusion criteria were the diagnosis of cataract and end-stage glaucoma with a cup-disc ratio (CD) of 0.9-1.0 and marked visual field defects with partially preserved central function. Preoperatively, at the third postoperative day and after 6 months (2-11 months), the visual acuity (V), the intraocular pressure (IOP), the number of antiglaucomatous drugs and the visual fields were assessed. Furthermore, the surgical procedure and possible complications were noted. In all patients cataract surgery was performed with topical anaesthesia.


RESULTS
10 patients were treated with cataract surgery alone, whereas 2 patients underwent combined cataract and glaucoma surgery. The mean visual acuity improved significantly from 0.3 to 0.5 (p = 0.007). Additionally a significant intraocular pressure reduction of 4.4 mm Hg (p = 0.007) was observed. The number of antiglaucomatous drugs decreased from 1.5 preoperatively to 0.8 postoperatively. The mean deviation (MD) improved from -27.5 dB up to -26.4 dB (p = 0.036) after 6 months.


CONCLUSIONS
Patients with progressive cataract and end-stage glaucoma can benefit from cataract surgery. Although marked visual field defects were present, an increase in visual acuity as well as a decrease of intraocular pressure may be achieved without worsening of the visual fields.
Altmeyer
M
M
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin. mathias.altmeyer@vivantes.de
Wirbelauer
C
C
Häberle
H
H
Pham
D T
DT
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005901:Glaucoma / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*