Angle-closure glaucoma: Surgical management of acute angle-closure glaucoma

Abstract

The initial treatment for acute primary angle-closure aims to reduce the intraocular pressure (IOP) as rapidly as possible to relieve symptoms and prevent further ocular tissue damage. Traditionally, IOP is lowered by topical or systemic hypotensive medications, which often will break the acute attack, and then the pupillary block is relieved by laser peripheral iridotomy (LPI). A number of groups across the world have described other procedures to break an attack of acute angle-closure, including argon laser peripheral iridoplasty, immediate anterior chamber paracentesis, and early cataract or lens extraction by phacoemulsification [1-12]. While these procedures can work to break an attack, they have not been widely adopted due to potential complications and the fact that they may not resolve the problem of pupillary block (except in the case of cataract extraction). © 2010 Springer-Verlag Berlin Heidelberg.