- Cataracts and glaucoma are different eye diseases that often coexist in older adults.
- Traditional glaucoma surgery is more invasive, but MIGS techniques are designed for combination with cataract surgery.
- Combined cataract-MIGS procedures can lower eye pressure, reduce medication needs, and restore clear vision at the same time.
- Not everyone is a candidate — your surgeon will evaluate cataract maturity, glaucoma type, and severity.
- Desert Vision Center offers iStent inject, Hydrus Microstent, OMNI canaloplasty, and Kahook Dual Blade MIGS procedures.
Do you have glaucoma but also need to have your cataracts removed? You may be wondering if you are able to treat cataracts and glaucoma at the same time. The good news is that thanks to minimally-invasive glaucoma surgery (MIGS), this is possible. MIGS procedures can be combined with cataract surgery for patients with cataracts and mild to moderate open-angle glaucoma. MIGS techniques, as the name suggests, are less invasive. They also use the same incision your surgeon creates when they remove your cataracts. It’s possible to have both cataracts and glaucoma even though they are two different conditions. Keep reading to learn more about how to treat glaucoma and cataracts with MIGS procedures.
Cataracts
Cataracts are an almost inevitable part of aging that occurs when the natural lens of the eye becomes cloudy. With cataracts, it’s quite common to experience blurry or hazy vision. Other symptoms of cataracts that you may experience are:
- Double vision
- Difficulty when driving at night
- Halos and glares
- Increased sensitivity to light
You may not realize you have cataracts at first, as it can take many years for a cataract to develop. Once you find out you have cataracts, you may not need cataract surgery until they make it difficult to complete everyday activities.
Glaucoma
Glaucoma is a group of eye diseases that cause irreversible damage to the optic nerve usually due to high intraocular pressure. There are different types of glaucoma, but the most common is open-angle glaucoma. Symptoms of open-angle glaucoma include blind spots and tunnel vision, although most people with glaucoma don’t realize they have it until the later stages of the disease when they’ve already developed vision loss. Although anyone can have glaucoma, some factors increase your risk of developing the condition, including:
- Being 60 years or older
- Having a family history of glaucoma
- Diabetes
- Severe eye trauma
- Extreme nearsightedness
- Hispanic, African American, or Asian heritage
- Long-term use of corticosteroid medications
The best line of defense against glaucoma is to schedule regular eye exams with your eye doctor. Though there is no cure for the condition, early diagnosis and treatment help manage it and preserve your remaining vision.
Is it Safe to Combine Cataract and Glaucoma Procedures?
If glaucoma and cataracts are left untreated, they can cause vision loss. Having cataract surgery is the only way to treat cataracts and regain your clear vision. For some patients, undergoing a surgical procedure to treat their glaucoma is necessary.
Watch how MIGS procedures can be combined with cataract surgery for dual treatment.
It’s important to note that some patients with glaucoma and cataracts may not qualify for a procedure that combines them. The decision to perform both procedures simultaneously will depend on how mature your cataracts are, your type of glaucoma, and its severity, among other factors. At Desert Vision Center, Dr. Tokuhara will consider all the necessary factors before recommending the best treatment like MIGS to protect your vision and sight. Depending on your eye condition, Dr. Tokuhara may recommend MIGS as a stand-alone procedure as well.
Minimally-Invasive Glaucoma Surgery (MIGS)
Most of the MIGS procedures performed will leave the tissues of the eye typically used during traditional glaucoma surgeries intact. Doing this ensures the possibility of being able to undergo future treatment options. Compared to traditional glaucoma procedures like a trabeculectomy, MIGS is both easier and quicker to perform. It also has fewer risks of complications occurring.
What to Expect During MIGS
Although it can differ depending on the MIGS procedure, these procedures usually take about 15 to 20 minutes for each eye. The first step in a combined procedure is to remove the natural lens where the cataract has formed. After removing the clouded lens where the cataract is, and replacing it with an artificial lens, known as an intraocular lens (IOL), the MIGS portion of the procedure begins. Micro-invasive glaucoma surgery adds no significant risk to the cataract procedure.
Treating Cataracts and Glaucoma at the Same Time
Various minimally invasive glaucoma surgery procedures make it possible to treat glaucoma while you’re having your cataracts removed during cataract surgery. At Desert Vision Center, we offer the following MIGS procedures:
The iStent inject is an effective option for glaucoma patients who also need cataract surgery. It helps manage increased intraocular pressure due to glaucoma, reducing dependence on glaucoma medications. The iStent inject comprises two tiny shunts used to create double and separate pathways in your trabecular meshwork. As a result, your eye can drain aqueous adequately, decreasing pressure inside the eye. This FDA-approved device has proven to be safe and highly successful.
The Hydrus microstent is a minimally invasive stent about the size of an eyelash. It is placed into Schlemm’s Canal, providing a direct flow of aqueous pressure. The microstent has three windows which create a 90-degree scaffold that helps keep Schlemm’s Canal open and expands the eye’s pathway for fluid movement. Implantation helps lower intraocular pressure and can be combined with cataract surgery. For some, the stent decreases reliance on eye drops; others may no longer need medication.
The OMNI canaloplasty is an implant-free MIGS procedure. It uses a microcatheter that moves through Schlemm’s Canal, opening and breaking adhesions 180 to 360 degrees. Once the microcatheter is retracted, viscoelastic is deployed into the canal, opening the outflow pathway and reducing pressure. While it doesn’t cure glaucoma, it slows progression. Because it’s minimally invasive, there’s less risk for scarring and complications.
The Kahook Dual Blade allows your surgeon to create a small incision in the trabecular meshwork and the wall of Schlemm’s Canal, releasing intraocular pressure and enhancing fluid outflow. It is a good option for patients with open-angle glaucoma. The procedure uses a disposable blade and can be performed with cataract surgery without affecting recovery, thanks to its low risk of infections or leaks. In 2018, Dr. Tokuhara became the first surgeon in Coachella Valley to successfully perform the Kahook Dual Blade Goniotomy.
Specialized Treatment for Patients with Glaucoma and Cataracts
If you have both glaucoma and cataracts, Dr. Tokuhara can help. Desert Vision Center’s board-certified cataract surgeon and fellowship-trained retina specialist use MIGS to deliver the most advanced and effective treatment for patients with glaucoma and cataracts. We also offer advanced technologies like the ORA System for precise IOL selection and premium lens options to reduce glasses dependence after cataract surgery.
Do you have cataracts and glaucoma? Find out if a MIGS procedure may be right for you by scheduling a consultation at Desert Vision Center in Rancho Mirage, CA, now.
Don’t wait to protect your sight
If you have both cataracts and glaucoma, a single combined procedure could restore your vision and manage eye pressure at the same time. Schedule a consultation with Dr. Tokuhara at Desert Vision Center in Rancho Mirage, CA, to find out if MIGS is right for you.