The accelerated development of cataract is frequently seen in the years following glaucoma filtration surgery (1). Cataract surgery causes anterior chamber inflammation which has been shown to persist for up to six months after surgery (2). When performed after trabeculectomy, there is an increased risk of trabeculectomy failure associated with a shorter time interval between filtration surgery and subsequent cataract surgery (3). Although adjunctive treatments are often used to promote trabeculectomy survival when performing cataract surgery, there is no robust evidence currently available to support this (4).
The timing of cataract surgery in patients with a functioning drainage bleb should be carefully considered to mitigate this risk. These patients require closer post-operative monitoring and an increased duration of topical steroid therapy to achieve long-term trabeculectomy survival.
EGS Guidelines, 5th Edition, Pages 43,164, 169
Pearls Manager: Hari Jayaram