Presence of Glaucoma Should Not Preclude Advanced IOL Use, But …

“Just because a patient has glaucoma, it does not mean he should receive a blanket ban for advanced technology intraocular lenses,” noted Arup Chakrabarti, MD, senior consultant at the Chakrabarti Eye Care Centre in Trivandrum, India, during the 2018 APACRS annual meeting in Chiang Mai, Thailand. Dr. Chakrabarti reviewed these important considerations: 

• Trabeculectomy surgery can induce with the rule corneal astigmatism. As intraocular pressure is lowered after trabeculectomy, watch for a decrease in axial length. 
• Also look for an increase in axial length after cataract extraction, as well as a decrease in such after phacoemulsification. 
• Patients with moderate to advanced glaucoma can experience reduced contrast sensitivity decreases in other visual functions. These conditions could aggravate some of the optical issues seen with multifocal lenses. 

Chakrabarti A.  Keys to finding the right path in refractive cataract surgery. Talk presented at: 2018 APACRS annual meeting; July 19-21, 2018; Chiang Mai, Thailand.