Cataract extraction in an eye with filtering bleb.

Seventy-two ophthalmologists with a major interest in glaucoma (glaucoma surgeons) responded to a questionnaire as to how they would remove a cataract from a hypothetical 60-year-old patient with a functioning filtering bleb in the superior nasal quadrant. The majority recommended an intracapsular cataract extraction through a lateral or inferolateral limbal incision or a superior corneal incision anterior to the bleb. Most of the glaucoma surgeons preferred to close the wound with five to nine interrupted 10-0 nylon sutures. Estimates of the percentage of blebs failing after cataract extraction ranged from zero to more than 50%, with a median of 30%. The majority of the glaucoma surgeons stated that they would never, or only under exceptional circumstances, implant an intraocular lens in an eye with a filtering bleb. Twelve ophthalmologists with a major interest in intraocular lens implantation (implant surgeons) responded to the same questionnaire. They were more likely than the glaucoma surgeons to recommend extracapsular cataract extraction and to implant an intraocular lens in an eye with a filtering bleb.