By Graham A. Lee, Ivan Goldberg (auth.), Sandra M. Johnson (eds.)
The coexistence of cataract and glaucoma is usual and administration of a cataract could have major impression at the glaucoma prestige of a sufferer. this article makes a speciality of the remedy of cataract within the atmosphere of glaucoma utilizing an evidence-based medication method. dealing with cataracts to the easiest benefit of the glaucoma should still bring about the simplest visible results for sufferers. Cataract surgical procedure within the Glaucoma sufferer is an excellent source for ophthalmologists who take care of glaucoma patients.
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Extra info for Cataract Surgery in the Glaucoma Patient
Cortex Removal An iris manipulator instrument through the paracentesis can be used to retract the iris and inspect for residual nucleus or cortical remnants. Bimanual cortical removal instruments are useful for retrieving subincisional cortex. Postoperative Care Eyes that have undergone iris manipulation of any sort are more prone to postoperative inﬂammation and are therefore more at risk for developing cystoid macular edema (CME). Preoperative and postoperative NSAIDs can help reduce inﬂammation and the incidence of CME.
This can be carefully stripped with a capsulorhexis forceps prior to additional pupil expansion techniques. Any of the pupil expansion techniques can be successful in these eyes. Congenital, Acquired, Traumatic, Surgically Altered Pupils Eyes with congenital, acquired, traumatic, or surgically altered pupils may also develop glaucoma and present significant challenges during cataract surgery. Congenital abnormalities such as ectopia lentis et pupillae or traumatic pupil injury such as iridodialysis may also have weakened zonules or subluxed crystalline lenses.
By carefully watching the iris sphincter during a slow stretch maneuver, the surgeon can avoid this type of uncontrolled tear by stopping when the ﬁne microtears of the sphincter have formed. Stretching should not be used in patients with likely IFIS because it will precipitate pupil constriction in those eyes. 5 Because no disposable device is used, it is less costly. Instrument-assisted stretching entails a one-time cost to purchase the instrument and also special care to clean and ensure smooth operation.