Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma

Global Glaucoma Academy

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations

Abstract

The crystalline lens plays an important role in the pathophysiology of primary angle closure and primary angle-closure glaucoma. The aging process is associated with a progressive enlargement of the lens, resulting in greater iridolenticular and iridotrabecular contact, which exacerbates both pupillary block and appositional angle closure, irrespective of the cataract status of the lens. Cataract surgery has been shown to widen the angle and reduce intraocular pressure in eyes with primary angle closure or primary angle-closure glaucoma. Recently, clear lens phacoemulsification has been suggested as a treatment modality in such eyes. We review the literature on clear lens extraction in eyes with angle closure and discuss its efficacy, safety, and indications. Although it is evident that clear lens extraction is beneficial in eyes with primary angle closure and primary angle-closure glaucoma, it is technically challenging and should be performed by experienced surgeons who not only master the procedure but are also able to deal with potential complications. Since the follow-up of the reviewed studies is relatively short, long-term follow-up (>10 years) of patients who undergo this procedure is needed to evaluate the safety and confirm the early benefits reported.

Original languageEnglish
Pages (from-to)662-674
Number of pages13
JournalSurvey of Ophthalmology
Volume65
Issue number6
DOIs
StatePublished - 1 Nov 2020

Keywords

  • angle closure glaucoma
  • anterior segment OCT
  • cataract
  • gonioscopy
  • intraocular pressure
  • phacoemulsification
  • quality of life

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