Lens extraction: Where does it stand in the primary angle closure glaucoma management algorithm?

Abstract

Cataractous or not, the lens in primary angle closure glaucoma (PACG) eyes is likely to be pathologically too thick and anteriorly positioned, and is one important contributing factor to angle closure. Extraction of the lens reverses the anatomical predisposition to angle closure and also significantly improves IOP control in PACG. Based on emerging evidence from recent clinical trials, lens extraction may play an important role in the surgical management of PACG, whether alone or in combination with other IOP-lowering interventions. Combined procedures such as phaco-Trabeculectomy may be considered if greater IOP-lowering is desirable or if drug dependency must be minimized, but the associated complication risk is higher. © Informa UK, Ltd.