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What Percentage of Cataract Surgeries Are Performed in Patients With Glaucoma?

Cataract and glaucoma are two of the most common age-related eye diseases, and they frequently coexist. Studies estimate that between 15 percent and 25 percent of all cataract surgeries are performed in patients who also have a confirmed diagnosis of glaucoma or ocular hypertension. This high prevalence of coexisting disease necessitates careful, combined surgical planning to manage both conditions simultaneously.

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What Percentage of Cataract Surgeries Are Performed in Patients With Glaucoma?

Cataract and glaucoma are two of the most common age-related eye diseases, and they frequently coexist. Studies estimate that between 15 percent and 25 percent of all cataract surgeries are performed in patients who also have a confirmed diagnosis of glaucoma or ocular hypertension. This high prevalence of coexisting disease necessitates careful, combined surgical planning to manage both conditions simultaneously.

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What are the Surgical Planning Considerations for Coexisting Disease?

Surgical planning considerations are complex. The primary goal is to safely remove the cataract (improving vision) while either stabilizing or lowering the intraocular pressure (IOP) associated with glaucoma. This often leads to a combined procedure, such as cataract surgery followed immediately by a minimally invasive glaucoma surgery procedure. The choice of intraocular lens (IOL) is also important, as multifocal IOLs may be avoided in eyes with significant glaucoma damage.

How Does Cataract Surgery Affect Intraocular Pressure (IOP)?

Cataract surgery often has a beneficial effect on IOP. Removing the large, dense natural lens allows more space in the front of the eye, improving the outflow of aqueous humor. Studies show that cataract surgery alone can lower IOP by a few points, but this effect is often temporary, which is why a combined glaucoma procedure is frequently necessary.

What are the Outcomes of Combined Procedures?

The outcomes of combined procedures aim for dual benefits. The combination of cataract removal and a MIGS procedure successfully improves visual acuity while simultaneously reducing the patient's dependence on topical glaucoma drops. The success rate depends heavily on the severity of the pre-existing glaucoma damage.

What are the Risks of Performing Cataract Surgery on a Glaucomatous Eye?

The risks include a temporary spike in IOP immediately after surgery or the failure of a previously constructed glaucoma drainage device. Surgeons must manage post-operative inflammation aggressively to prevent complications that could worsen the glaucoma damage.

What is the Role of IOL Selection?

The role of IOL selection is important. In advanced glaucoma cases, surgeons often choose a standard monofocal lens over a multifocal lens, as the optic nerve damage may limit the patient's ability to benefit from the complex optics of a multifocal lens.

FAQs on Cataract and Glaucoma

Is glaucoma curable by cataract surgery?

No, glaucoma is not curable by cataract surgery, but the surgery often helps lower the eye pressure.

What is a MIGS procedure?

MIGS (Minimally Invasive Glaucoma Surgery) are small procedures performed at the time of cataract surgery to enhance fluid drainage and lower eye pressure.

Does a cataract worsen glaucoma?

Yes, a large, advanced cataract can physically push the iris forward, narrowing the drainage angle and worsening glaucoma.

When to See Your Doctor

If you have both glaucoma and a visually significant cataract, consult a glaucoma specialist to discuss combined surgical options. A detailed preoperative discussion regarding the goal of pressure control versus vision quality is necessary.

References

  • American Academy of Ophthalmology. Combined Cataract-Glaucoma Surgery and MIGS: Benefits and Patient Selection (aao.org/eye-health/treatments/combined-cataract-glaucoma-surgery-facts). 2025.
  • EyeWorld. Who Should Be Performing Glaucoma Surgery in 2025? Co-Diagnosis and Surgical Skill Sets (eyeworld.org/2025/who-should-be-performing-glaucoma-surgery-in-2025). 2025.
  • Journal of Glaucoma. Prevalence of Glaucoma in Cataract Surgery Patients: A Global Meta-Analysis of Coexisting Ocular Disease (journals.lww.com/glaucomajournal). 2025.
  • Journal of Cataract & Refractive Surgery. Five-Year Outcomes of Combined Phacoemulsification and Minimally Invasive Glaucoma Surgery (MIGS) (jcrsjournal.org). 2025.
  • Mayo Clinic. Cataracts and Glaucoma: Understanding Combined Treatment Options and Postoperative IOP Management (mayoclinic.org/diseases-conditions/cataracts/diagnosis-treatment/drc-20353795). 2026.