Katarakt-Operation bei Patienten mit Glaucoma fere absolutum

Abstract

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.

The outcome of cataract surgery in eyes with end–stage glaucoma

“…The results of our study, which showed a significantly improved BCVA without worsening of the VF after PHACO IOL, are similar to those previously reported (1,3,6). The IOP and the number of antiglaucoma medications after PHACO IOL in our study were stable.…”

“…That is why surgeons may be hesitant about recommending PHACO IOL for patients with end-stage glaucoma, because of concerns regarding the possibility of the occurrence of the "wipe-out" phenomenon and the questionable improvement of functional vision. Therefore, only few reports are available dealing with the outcome of PHACO IOL in eyes with endstage glaucoma (1,3,6).…”

“…In their prospective study, which included 12 eyes with advanced cataract and end-stage glaucoma, Altmeyer et al evaluated the benefit of cataract surgery (1). Ten eyes were treated with PHACO IOL alone, whereas two patients underwent combined cataract-glaucoma surgery (PHACO IOL and trabeculectomy).…”

“…Improving the functional vision of patients in everyday life is a key goal of cataract surgery. In recent years, there has been controversy surrounding the benefits of cataract surgery for patients with coexisting cataract and end-stage glaucoma (1,2,3,4). Intraocular procedures, especially filtration surgery in patients with end-stage glaucoma, can produce perfusion alterations of the optic nerve head which can result in severe loss of central vision (4,5).…”

“…Given the severity of visual field (VF) defects in end-stage glaucoma, the improvement of functional vision after cataract surgery may be questionable. It has been reported that cataract extraction in eyes with end-stage or severe glaucoma can result in improved visual acuity and a decrease of intraocular pressure (IOP), but the improvement in VF is less predictable (1,3,6). In our prospective clinical study we evaluated the outcome of phacoemulsification and intraocular lens implantation (PHACO IOL) in eyes with end-stage glaucoma.…”