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July 1970

Cataract Extraction in Glaucomatous Patients

Author Affiliations

St. Louis
From the Glaucoma Center, Department of Ophthalmology, Washington University School of Medicine, St. Louis. Dr. Stewart is a fellow of the Heed Foundation and is now with the Hermann Hospital, Houston. Dr. LeBlanc is a fellow of the R. S. McLaughlin Foundation, Toronto.

Arch Ophthalmol. 1970;84(1):63-64. doi:10.1001/archopht.1970.00990040065015

CATARACT formation with resultant reduction of vision is a frequent occurrence in patients receiving miotic therapy for glaucoma. This is especially true when using cholinesterase inhibitors which produce such intense miosis that the visual impairment from even minimal lens changes is greatly magnified. The development of proliferations of the pigment epithelium of the iris may cause further reduction of the pupillary opening in patients using these agents. In addition, individuals subjected to prolonged use of anticholinesterase drugs may develop central anterior subcapsular vacuoles and opacities. The necessity for cataract surgery, therefore, often arises in the long-term follow-up of glaucoma patients.

Since the glaucoma patient will often require miotics postoperatively, it is advisable to create a permanent large pupillary opening at the time of cataract surgery. The advantages of the larger opening are twofold. First, during the operative procedure, the delivery of the lens is facilitated. Second, postoperatively, the fundus can

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