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New options for combined cataract and glaucoma surgery

Budenz, Donald L.a; Gedde, Steven J.b

Current Opinion in Ophthalmology: March 2014 - Volume 25 - Issue 2 - p 141–147
doi: 10.1097/ICU.0000000000000027
GLAUCOMA: Edited by Donald L. Budenz

Purpose of review To review the current literature regarding the effectiveness and risks of new surgeries that can be combined with phacoemulsification in the management of cataract and glaucoma.

Recent findings Surgical options for concurrently managing cataract and glaucoma have expanded in recent years. Endoscopic cyclophotocoagulation, trabecular micro-bypass stent, ab interno trabeculectomy, and canaloplasty may be performed in conjunction with cataract extraction to provide additional intraocular pressure (IOP) reduction. Studies evaluating these new glaucoma procedures combined with phacoemulsification generally include retrospective case series without a comparison group. Because cataract surgery alone is associated with IOP reduction, the relative contribution of the glaucoma procedure in lowering IOP cannot be determined in these studies. Randomized clinical trials are needed to better evaluate the efficacy and safety of newer glaucoma procedures in combination with cataract surgery.

Summary The newer glaucoma procedures appear less effective than trabeculectomy, but they are associated with a lower risk of surgical complications.

aDepartment of Ophthalmology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

bBascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA

Correspondence to Donald L. Budenz, MD, MPH, 5151 Bioinformatics, CB7040, Chapel Hill, NC 27517, USA. Tel: +1 919 843 0297; fax: +1 919 966 1908; e-mail:

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