In patients with chronic angle-closure glaucoma and cataract, phacoemulsification with IOL implantation usually results in IOP control up to 2 years after surgery

The Science behind the Tip

An anteriorly positioned and thickened lens plays an important role in the pathogenesis of anterior chamber shallowing in primary angle-closure glaucoma(1).

In individuals with chronic angle-closure glaucoma and cataract, phacoemulsification with IOL implantation usually results in improved IOP control up to 2 years after surgery, whether the preoperative IOP is medically controlled or not(2).

The intraoperative complication rate of 5-8% is higher than usual. Less topical medication to reduce IOP is needed post-operatively. In those patients with controlled preoperative IOP who undergo phacoemulsification, 3% subsequently need a trabeculectomy, compared to 15% with uncontrolled preoperative IOP.

Contributor: J F Salmon - Oxford Eye Hospital, Oxford, UK

References

1. Tarongy P, Ho CL, Walton DS. Angle-closure: the role of the lens in pathogenesis, prevention and treatment. Surv Ophthalmol. 2009;54:211-25

2. Tham CC, Kwong YY, Leung DY et al. Phacoemulsification versus combined phacoemulsification in medically controlled chronic angle-closure glaucoma. Ophthalmology. 2008;115:2167-73.

Tip Reviewer: Roger Hitchings
Tip Editors: Ann Hoste, John Salmon and John Thygesen