Glaucoma with Cataracts: How Can I Treat Both?

Eye Care & Surgery Center NJ Bladeless LASIK Laser Cataract Surgeon Blog

Thursday, June 9, 2011

Glaucoma with Cataracts: Can I Treat Both?

Endoscopic Cyclophotocoagulation (ECP) & Cataract Surgery
The treatment of coexisting cataract and glaucoma is a complex issue. For some patients who have this combined problem, cataract extraction combined with ECP is our procedure of choice.

Simultaneous Cataract and ECP Surgery could allow you to improve your vision while reducing, or completely eliminating your dependence on Glaucoma medications. Each of these surgical procedures lasts only a few minutes, using highly refined, minimally invasive, surgical techniques and state of the art instrumentation. ECP is a surgical technique that inhibits the production of aqueous in the eye, typically resulting in a decrease in intraocular pressure and the reduction or elimination of a patient's dependence on glaucoma medications. Simultaneous Cataract & ECP Glaucoma Surgery is also convenient, typically reducing the frequency, number and costs of glaucoma medications for patients, and requiring no more follow-up visits than for cataract surgery alone.

The ECP procedure is performed using a state-of-the art laser microendoscope. Endoscopy, which allows surgeons to view and treat internal structures through a small incision, (as in Arthroscopic knee surgery for example), has revolutionized minimally invasive surgery, affording patients quicker and more comfortable recoveries along with improved and more predictable outcomes. The microendoscope chosen for our facility is a unique instrument. It is about the diameter of a small paper clip, the smallest medical endoscope developed to date.

It utilizes an integrated imaging and laser fiberoptic bundle to allow simultaneous viewing and highly targeted treatment of the surface cells of the ciliary processes. The ciliary processes are a series of organs located below the base of the underside of the iris which exude aqueous fluid into the eye.

During combined cataract and ECP glaucoma surgery the laser microendoscope is introduced through a small incision already made during the cataract procedure. Both surgeries are performed under local anesthesia on an out patient basis.

While there are other surgical options to treat glaucoma, ECP is offered because it provides the following:

• Excellent Safety Record
• Predictable, Improved Outcomes
• Uncomplicated Follow-Up
• Fast Recovery

ECP can also be performed without simultaneous cataract surgery. Pre-emptive to glaucoma filtering surgery, ECP in conjunction with SLT (Selective Laser Trabeculoplasty), may be used in an attempt to better control glaucoma and improve pressure lowering of glaucoma without more invasive and dangerous surgery. However, if the ECP still fails to control the glaucoma, then standard glaucoma surgery may still be performed.

Thank you to Dr. Ivan Jacobs, our guest blogger today, for sharing his insights and knowledge with us.