Abstract
With the advancement of technology and the development of phacoemulsification, lens extraction can now be performed through smaller corneal incisions with minimal conjunctival manipulation and intraoperative intraocular pressure fluctuations. For different stages of Primary Angle Closure diseases, phacoemulsification alone or combined with glaucoma procedures are important surgical treatment options in the control of intraocular pressure and disease progression. This chapter will illustrate the algorithm in the choice of surgery in different scenarios with the display of recent evidence. We will also discuss the potential perioperative risk and complications aside from its preventive measures in this group of patients.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Deng BL, Jiang C, Ma B, et al. Surgical treatment for primary angle-closure glaucoma: a meta-analysis. Int Ophthalmol. 2011;4(3):223–7.
Tham CC, Kwong YY, Leung DY, et al. Phacoemulsification versus combined phacotrabeculectomy in medically uncontrolled chronic angle closure glaucoma with cataracts. Ophthalmology. 2009;116(4):725–31.
Hansapinyo L, Choy BNK, Lai JSM, et al. Phacoemulsification versus phacotrabeculectomy in primary angle-closure glaucoma with cataract: long term clinical outcomes. J Glaucoma 2019 Nov 6; 29:15. https://doi.org/10.1097/IJG.0000000000001397. Epub ahead of print.
Lai JS, Tham CC, Chan JC. The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and coexisting cataract: a prospective case series. J Glaucoma. 2006;15(1):47–52.
Tham CC, Leung DY, Kwong YY, Li FC, Lam DS. Effects of phacoemulsification versus combined phaco-trabeculectomy on drainage angle status in primary angle closure glaucoma (PACG). Glaucoma. 2010;19(2):119–23.
Tham CCY, Kwong YYY, Leung DYL, Lam SW, Li FCH, Chiu TYH, Chan JCH, Lam DSC, Lai JSM. Phacoemulsification vs phacotrabeculectomy in chronic angle-closure glaucoma with cataract complications. Arch Ophthalmol. 2010;128(3):303–11.
Man X, Chan NC, Baig N, et al. Anatomical effects of clear lens extraction by phacoemulsification versus trabeculectomy on anterior chamber drainage angle in primary angle-closure glaucoma (PACG) patients. Graefes Arch Clin Exp Ophthalmol. 2015;253:773–8.
Tham CC, Kwong YY, Baig N, Leung DY, Li FC, Lam DS. Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle-closure glaucoma without cataract. Ophthalmology. 2013;120(1):62–7.
Azuara-Blanco A, Burr J, Ramsay C, et al., EAGLE Study Group. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet 2016;388:1389–1397.
Lam DS, Leung DY, Tham CC, et al. Randomized trial of early phacoemulsification versus peripheral iridotomy to prevent intraocular pressure rise after acute primary angle closure. Ophthalmology. 2008;115(7):1134–40.
Husain R, Gazzard G, Aung T, et al. Initial management of acute primary angle closure: a randomized trial comparing phacoemulsification with laser peripheral iridotomy. Ophthalmology. 2012;119:2274–81.
Pathak Ray V, Puri V, Peguda HK. Intra-operative ASOCT determined changes in angle recess in plateau iris syndrome post phaco alone and post phaco-endocycloplasty. Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):663–4.
Ruben S, Tsai J, Hitchings RA. Malignant glaucoma and its management. Br J Ophthalmol. 1997;81(2):163–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Chan, N.CY., Tham, C.C.Y. (2021). Lens Extraction in PACG. In: Tham, C.C. (eds) Primary Angle Closure Glaucoma (PACG). Springer, Singapore. https://doi.org/10.1007/978-981-15-8120-5_8
Download citation
DOI: https://doi.org/10.1007/978-981-15-8120-5_8
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-8119-9
Online ISBN: 978-981-15-8120-5
eBook Packages: MedicineMedicine (R0)