Media Type: Textbook

Synopsis: I highly recommend Cataract Surgery in the Glaucoma Patient , edited by Sandra Johnson, to anyone performing cataract surgery in the glaucoma patient. The book begins with a fantastic overview of the pre-operative approach, including excellent pictures and an outstanding literature review. There is an extensive discussion on combined cataract surgery including the latest incisional glaucoma surgery techniques. My favorite part of the book is the post-operative management which provides outstanding descriptions along with great summary figures and tables that allow you to easily understand the authors’ approach. The book ends with an expansive look at specific glaucoma conditions.

Target Audience: Glaucoma and cataract surgeons.

Review: Cataract Surgery in the Glaucoma Patient , edited by Sandra Johnson, provides you with the knowledge and the insight into the arena of cataract surgery in the glaucoma patient.

The book starts with a complete overview of the pre-operative approach to the glaucoma patient undergoing cataract surgery. These initial chapters give you the insight that you need prior to performing surgery on these sometimes challenging patients. The chapters are complimented by excellent pictures and an outstanding literature review.

The intra-operative section of the book discusses the various techniques such as combining cataract surgery with antimetabolite trabeculectomy, glaucoma drainage devices, and endolaser cyclophotocoagulation. They expand on the intra-operative findings that can occur with the glaucoma patients, such as the prevalent small pupil and how to address these intra-op conditions. The book is very current with the latest techniques in glaucoma incisional surgery, such as express shunt, canaloplasty, IStent, and Trabectome. There are excellent intra-operative pictures to facilitate the dialogue. Figure 14.44: “The current landscape in glaucoma with intraocular pressure (IOP) lowering techniques plotted versus risk to patient,” is one of my favorites.

My favorite part of the book is the post-operative management of these patients. Post-operative issues, probably the most challenging aspect of cataract surgery in the glaucoma patient, are completely covered. Table 9.6: “Bleb evaluation in the immediate postoperative period,” and Figure 19.6: “Diagram of the differential diagnosis of complications following phacotrabeculectomy,” are outstanding. Tables 21.1 and 21.2 beautifully summarize the differential diagnosis of increased IOP following cataract surgery based on time of onset and status of anterior chamber. These 4 diagrams contain essential information that you need to know to stabilize IOP besides obtaining visual rehabilitation.

There is a great review of the most common post-op issue – elevation of IOP. It goes on to explain the early post-op maintenance of a filtration bleb. The recognition, diagnosis, and treatment of choroidal detachments are appropriately given its own chapter to discuss and outline this clinical scenario. When situations need to be addressed, not only is the treatment needed explained in detail, but any preparation and dosages are also listed.

The book ends with an extensive look at specific conditions that you need to be aware of, respect, and address when performing cataract surgery. There is a complete review of pseudoexfoliation. The chapter addresses intra-operative signs of pending complications such as anterior capsule striae and deepening of the anterior chamber. Chapters covered also include avoiding a filtration bleb and revising a failing filtration bleb or glaucoma drainage device, cataract surgery in primary angle closure glaucoma, nanophthalmos, cataract induced glaucoma, retinopathy of prematurity, and performing cataract surgery on a hypotonus eye.

There were a couple of editing mistakes with some of the figures, but they were easy to decipher and did not detract from the overall benefit of the book. A DVD showing the various surgical procedures that are described would have been a great supplement.

I highly recommend this book to anyone performing cataract surgery in the glaucoma patient.