Hickam’s dictum, which reminds clinicians that patients can have as many diseases as they please, is one of the first idioms aspiring physicians learn in their training. It’s especially true when it comes to ocular health, as diseases of the eye are often intertwined with other ocular and systemic conditions. Take glaucoma and cataracts, for instance. Both are more likely in patients older than 40 and even more prevalent in those older than 60.1,2 So, it’s likely patients will be booking appointments—and potentially undergoing surgery—for one while still battling the other. Researchers are now asking if cataract surgery has a long-term effect on patients with severe and end-stage glaucoma.3
The investigators performed a retrospective study of 19 eyes of 16 primary angle-closure glaucoma (POAG) patients who underwent cataract surgery alone or cataract surgery combined with goniosynechialysis from March 2015 to April 2018. All subjects had a preoperative IOP lower than 21mm Hg.3 They evaluated the patients’ visual acuities, IOPs, number of glaucoma medications and any complications.3
Final visual acuity was significantly improved in the severe and end-stage POAG patients, and the number of eyes free of medications increased by 57.8% after cataract surgery.3 At baseline, ten eyes registered IOPs above 15mm Hg, but by the April 2018 endpoint, only six were that high.3
1. Gupta P, Zhao D, Guallar E, et al. Prevalence of glaucoma in the United States: the 2005–2008 national health and nutrition examination survey. Invest Ophthalmol Vis Sci. 2016;57(6):2577–85.
2. Cataract Data and Statistics. National Eye Institute. www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/eye-health-data-and-statistics/cataract-data-and-statistics. July 17, 2019. Accessed April 30, 2020.
3. Fu L, Chan Y, Li J, et al. Long term outcomes of cataract surgery in severe and end stage primary angle closure glaucoma with controlled IOP: a retrospective study. April 16, 2021. [Epub ahead of print].