Refractive Outcomes Of Combined Cataract And Glaucoma Surgery At A VA Hospital

Abstract

Purpose: : This study was designed to evaluate the refractive outcomes of combined cataract extraction and glaucoma surgery.

Methods: : A retrospective chart review of patients undergoing simultaneous cataract extraction and either trabeculectomy or glaucoma drainage device (GDD) surgery at the Miami Veterans Affairs Medical Center (VAMC) was performed. Results were entered into a standard computerized database for subsequent analysis. The main outcome measure evaluated was whether or not spherical equivalent (SE) of -1.00 to +0.50 diopter (D) was achieved at 3 months post-operatively.

Results: : 54 eyes of 46 patients underwent combined cataract extraction and glaucoma surgery. The majority of patients were male (94%) with mean age of 71 +/- 11 years (range 46-90). Equal numbers of cataract/trabeculectomy and cataract/GDD surgeries were performed (48% vs. 52% respectively). Refractive outcome of SE between -1.00 and +0.5. was achieved in 37 of 50 eyes (74%) at 3 months. Logistic regression analysis found a 3.78 increased risk of failure to meet the defined refractive outcome in older compared to younger patients (by decade, 95% CI 1.51-9.50). Type of lens implant used, type of glaucoma surgery, use of adjunctive mitomycin-C, and post operative IOP did not significantly affect refractive outcome.

Conclusions: : Favorable refractive outcomes were achieved in the majority of patients despite the potential alteration of preoperative measurements and introduction of error into lens selection when using a combined approach. There does not appear to be a difference in the outcome measure based on type of glaucoma surgery performed.

Keywords: cataract • refractive error development • treatment outcomes of cataract surgery