Primary phacoemulsification for uncontrolled angle-closure glaucoma

Roberts, Timothy V.; Francis, Ian C.; Lertusumitkul, Sam; Kappagoda, Medduma B.; Coroneo, Minas T.

doi:10.1016/s0886-3350(00)00358-8

Cited by 93 publications

(43 citation statements)

References 14 publications

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“…One part of the evidence of lens factor is that cataract extraction lowers IOP by improving the angle configurations in ACG. [15][16][17][18][19] In our study, TCPD was slightly increased after LI or PT. CPI was decreased after both procedures.…”

Section: Discussionsupporting

confidence: 47%

Ultrasound Biomicroscopic Changes after Laser Iridotomy or Trabeculectomy in Angle-closure Glaucoma

Yoon

Won

Cho

et al. 2004

Korean J Ophthalmol

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This study was performed to demonstrate the ultrasound, biomicroscopic and dimensional changes of angle structure after laser iridotomy (LI) and primary trabeculectomy (PT) in primary angle-closure glaucoma (PACG). Angle-opening distance at a point 500(m from the scleral spur (AOD500), trabecular-iris angle (Θ 1 ), trabecular ciliary process distance (TCPD), ciliary process-iris angle (CPI), iris thickness (ID1, ID3), length of iris-lens contact distance (ILCD) and anterior chamber depth (ACD) were assessed before and after each procedure. Thirteen patients with LI and 16 with PT were prospectively enrolled. There were statistically significant increases in AOD500, Θ 1 , and ILCD in both groups. CPI was decreased in both groups. ACD, TCPD, and iris thickness were not changed significantly. The changes in angle configuration after LI or PT may result more from alterations in aqueous pressure gradients across the iris and the changes of configuration were greater in the iris roots without rotation of ciliary body. However, we didn't find any significant differences in the changes of parameters between the two procedures.

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Section: Discussionsupporting

confidence: 47%

Ultrasound Biomicroscopic Changes after Laser Iridotomy or Trabeculectomy in Angle-closure Glaucoma

Yoon

Won

Cho

et al. 2004

Korean J Ophthalmol

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“…Thus, phacoemulsification with posterior chamber IOL implantation is, in our opinion, becoming a first line therapy for eyes with PAC and cataract. Regarding the role of clear lens extraction in the management of PAC, only a few papers have addressed this matter [8,32]. The EAGLE study, which is due to report in 2014, will compare clinical outcomes and cost-effectiveness of clear lens extraction in PACG patients with standard care [33].…”

Section: Discussionmentioning

confidence: 99%

“…Angle width increases in most eyes after LPI, but between 20 and 25 % of eyes, show no change [6,7]. Several studies have demonstrated the efficacy of cataract surgery in chronic angle closure glaucoma [8,9], as well as in controlling IOP after an episode of acute angle closure glaucoma [10,11]. The objective of this study is to compare the long-term results of phacoemulsification with posterior chamber intraocular lens (IOL) implantation versus LPI in the management of chronic primary angle closure with cataract, in terms of clinical efficacy and anterior chamber parameters.…”

Section: Introductionmentioning

confidence: 94%

Phacoemulsification versus peripheral iridotomy in the management of chronic primary angle closure: long-term follow-up

et al. 2014

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Primary angle closure occurs as a result of crowded anterior segment anatomy, causing appositional contact between the peripheral iris and trabecular meshwork, thereby obstructing aqueous outflow. Several studies highlight the role of the crystalline lens in its pathogenesis. The objective of this work is to compare the long-term efficacy of phacoemulsification versus laser peripheral iridotomy (LPI) in the management of chronic primary angle closure (CPAC). Prospective case-control study with 30 eyes of 30 patients randomly divided in two groups: 15 eyes in the LPI group and 15 eyes in the IOL group. Patients in the LPI group underwent LPI using argon and Nd:YAG laser. Patients in the IOL group underwent phacoemulsification with posterior chamber intraocular lens (IOL) implantation. Examinations before and after the procedure included gonioscopy, Goldmann applanation tonometry, and anterior chamber evaluation using the Pentacam rotating Scheimpflug camera. The mean follow-up time was 31.13 ± 4.97 months. There was a statistically significant reduction in the intraocular pressure (IOP) and number of anti-glaucoma medications (p \ 0.01) only in the IOL group. Anterior chamber depth, angle, and volume were all higher in the IOL group (p \ 0.01) at the end of the follow-up period. Phacoemulsification with posterior chamber IOL implantation results in a higher anterior chamber depth, angle, and volume, when compared to LPI. Consequently, phacoemulsification has greater efficacy in lowering IOP and preventing its long-term increase in patients with CPAC and cataract.

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“…Furthermore, some surgeons advocate early extraction of a pathologically large lens, cataractous or not, for uncontrolled angle-closure glaucoma in order to lower the intraocular pressure [9][10][11] and prevent acute angle closure. [12][13][14][15][16] This is based on the fact that it has been reported that laser peripheral iridotomy alone is not sufficient to prevent a later rise in intraocular pressure, 22,23 although controversy regarding this remains. 24 The major problem of lens extraction and implantation of a monofocal IOL in patients with an early cataract is loss of normal accommodation.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, surgeons also sometimes consider the extraction of an anteriorly located, pathologically large lens with little or slight cataract formation for patients with primary angle-closure glaucoma, [9][10][11] because such surgery is effective in lowering intraocular pressure and in preventing an acute glaucoma attack. [12][13][14][15][16] In these patients, the major problem due to early cataract surgery is loss of normal accommodation.…”

Section: Introductionmentioning

confidence: 99%

Comparison of amplitude of apparent accommodation in pseudophakic eyes with that of normal accommodation in phakic eyes in various age groups

Hayashi

2005

Eye

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Primary phacoemulsification for uncontrolled angle-closure glaucoma

Abstract: Primary phacoemulsification with the option of future trabeculectomy should be considered in selected patients with persistent appositional angle closure and uncontrolled IOP after angle-closure glaucoma.

Cited by 93 publications

References 14 publications

Ultrasound Biomicroscopic Changes after Laser Iridotomy or Trabeculectomy in Angle-closure Glaucoma

Ultrasound Biomicroscopic Changes after Laser Iridotomy or Trabeculectomy in Angle-closure Glaucoma

Phacoemulsification versus peripheral iridotomy in the management of chronic primary angle closure: long-term follow-up

Comparison of amplitude of apparent accommodation in pseudophakic eyes with that of normal accommodation in phakic eyes in various age groups

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