Risks of Glaucoma Treatment in Patients with Cataracts

Amrendra  Kumar; Anita  Ambastha; Vidya Bhushan  Kumar

doi:10.51168/sjhrafrica.v5i9.1377

Authors

Amrendra Kumar Assistant Professor, Department of Ophthalmology, ESIC Medical College and Hospital, Bihta, Bihar, India
Anita Ambastha Additional Professor, Department of Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Vidya Bhushan Kumar Assistant Professor Department of Ophthalmology, ESIC Medical College and Hospital, Bihta, Patna, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i9.1377

Keywords:

Glaucoma, Cataract, Intraocular pressure, Cataract progression, Visual acuity, Glaucoma therapy

Abstract

Background: Glaucoma and cataract frequently coexist in older adults, with glaucoma being a leading cause of irreversible blindness and cataracts contributing to reversible vision loss. Medical therapy for glaucoma primarily targets intraocular pressure (IOP) reduction, but its potential effects on cataract progression are not fully understood. This study assessed the risks associated with medical glaucoma therapy in patients with cataracts.

Methods: A total of 100 patients diagnosed with both glaucoma and cataracts were recruited. Baseline data included age, cataract severity, and IOP measurements. Patients were followed at 1, 3, and 6 months to assess cataract progression, visual acuity changes, and any side effects related to glaucoma treatment. Statistical analysis involved paired t-tests for intraocular pressure changes and Chi-square tests for cataract progression.

Results: Thirty-five percent of participants experienced significant cataract progression, with those having more advanced baseline cataracts being at higher risk (p = 0.01). Mean IOP decreased significantly from 24.1 mmHg to 16.8 mmHg (p < 0.001) over the study period, indicating effective glaucoma control. Visual acuity worsened from 0.4 LogMAR to 0.6 LogMAR in patients with cataract progression (p = 0.02). Ocular side effects, such as dry eye and hyperemia, were reported in 25% of the cohort.

Conclusion: While medical therapy effectively controls IOP in glaucoma patients, it is correlated with an increased risk of cataract progression, particularly in those with severe cataracts at baseline. The decline in visual acuity highlights the need for careful monitoring of cataract status during glaucoma treatment.

Recommendations: For patients with coexisting glaucoma and cataracts, regular monitoring of cataract progression and adjustments to glaucoma therapy may be necessary. Consideration of alternative treatments, such as combined cataract and minimally invasive glaucoma surgeries, may optimize outcomes.