Surgical Treatment of Coexisting Cataract and Glaucoma. Evidence Report/Technology Assessment No. 38

摘要

Cataract and glaucoma are ocular diseases that often coexist, with prevalences over age 40 of 20 percent and two percent, respectively. There is no agreement concerning their optimal management when coexistent. This evidence report identifies the important questions pertinent to surgical treatment of coexisting cataract and glaucoma; assesses the quality and content of evidence on surgical treatment of coexisting cataract and glaucoma; and informs clinical practitioners and identifies areas for future research. The searches were conducted on publications from 1980 to April 2000 using two electronic databases, PubMed and CENTRAL. Quality scores for each controlled trial and cohort study were tabulated. Researchers concluded that there was strong evidence that glaucoma surgery is associated with an increased risk of postoperative cataract; moderately strong evidence that mitomycin-C, but not 5-fluorouracil is beneficial in combined procedures, limbus- and fornix-based conjunctival incisions are equally effective for lowering IOP, and the size of the phacoemulsification incision is not important; and weak evidence that combined procedures using phacoemulsification rather than nuclear expression result in lower long-term IOP, as do two-site compared to one-site combined procedures.