Phacoemulsification vs Phacotrabeculectomy in Chronic Angle-closure Glaucoma With Cataract

Abstract

To compare the complications of phacoemulsification alone vs combined phacotrabeculectomy in chronic angle-closure glaucoma (CACG) with coexisting cataract. Methods: Patients with CACG with coexisting cataract recruited into 2 randomized controlled trials comparing phacoemulsification alone vs combined phacotrabeculectomy were pooled for analysis. The first trial recruited patients with medically controlled intraocular pressure, while the second trial recruited patients with medically uncontrolled intraocular pressure. The 2 trials had otherwise identical study designs. All patients were reviewed every 3 months for 2 years after surgery. The main outcome measure was the surgical complications of phacoemulsification alone vs combined phacotrabeculectomy in CACG eyes with cataract. Results: One hundred twenty-three CACG eyes with cataract from 123 patients were included. Sixty-two CACG

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

“…Posterior capsular rupture, retrobulbar hemorrhage, and zonular dehiscence are the mostly encountered aspects. [ 16 ] In our case, the lens cortex was firmly adherent to the capsule bag, allowing easy posterior capsular tear. This highlighted that in patients with ACG who underwent cataract surgery, careful hydrodelination is necessary.…”

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

“…Posterior capsular rupture, retrobulbar hemorrhage, and zonular dehiscence are the mostly encountered aspects. [ 16 ] In our case, the lens cortex was firmly adherent to the capsule bag, allowing easy posterior capsular tear. This highlighted that in patients with ACG who underwent cataract surgery, careful hydrodelination is necessary.…”

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminologySupported by the EGS Foundation

“…In a study in CACG eyes with coexisting cataract, combined phacotrabeculectomy resulted in significantly more surgical complications than phacoemulsification alone. Visual acuity or disease progression did not differ between the 2 treatment groups 148 .…”

Factors Associated with Deterioration of Primary Angle Closure after Lens Extraction

“…Cataract, or clear lens extraction has been suggested as a treatment option for PACD, since it may reduce the risk of glaucomatous progression by opening the anterior chamber angle and, thus, controlling the IOP. Several studies have shown that lens extraction provides an opportunity to restore vision and significantly reduce IOP in PACD [6][7][8][9][10][11][18][19][20]. Especially, the EAGLE study emphasized the effectiveness of early lens extraction for the treatment of PACG in a randomized controlled trial [6].…”

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

“…Posterior capsular rupture, retrobulbar hemorrhage, and zonular dehiscence are the mostly encountered aspects. [ 16 ] In our case, the lens cortex was firmly adherent to the capsule bag, allowing easy posterior capsular tear. This highlighted that in patients with ACG who underwent cataract surgery, careful hydrodelination is necessary.…”

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminologySupported by the EGS Foundation

“…In a study in CACG eyes with coexisting cataract, combined phacotrabeculectomy resulted in significantly more surgical complications than phacoemulsification alone. Visual acuity or disease progression did not differ between the 2 treatment groups 148 .…”

Factors Associated with Deterioration of Primary Angle Closure after Lens Extraction

“…Cataract, or clear lens extraction has been suggested as a treatment option for PACD, since it may reduce the risk of glaucomatous progression by opening the anterior chamber angle and, thus, controlling the IOP. Several studies have shown that lens extraction provides an opportunity to restore vision and significantly reduce IOP in PACD [6][7][8][9][10][11][18][19][20]. Especially, the EAGLE study emphasized the effectiveness of early lens extraction for the treatment of PACG in a randomized controlled trial [6].…”

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

“…Posterior capsular rupture, retrobulbar hemorrhage, and zonular dehiscence are the mostly encountered aspects. [ 16 ] In our case, the lens cortex was firmly adherent to the capsule bag, allowing easy posterior capsular tear. This highlighted that in patients with ACG who underwent cataract surgery, careful hydrodelination is necessary.…”

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminologySupported by the EGS Foundation

“…In a study in CACG eyes with coexisting cataract, combined phacotrabeculectomy resulted in significantly more surgical complications than phacoemulsification alone. Visual acuity or disease progression did not differ between the 2 treatment groups 148 .…”

Factors Associated with Deterioration of Primary Angle Closure after Lens Extraction

“…Cataract, or clear lens extraction has been suggested as a treatment option for PACD, since it may reduce the risk of glaucomatous progression by opening the anterior chamber angle and, thus, controlling the IOP. Several studies have shown that lens extraction provides an opportunity to restore vision and significantly reduce IOP in PACD [6][7][8][9][10][11][18][19][20]. Especially, the EAGLE study emphasized the effectiveness of early lens extraction for the treatment of PACG in a randomized controlled trial [6].…”