What is the role of cataract surgery in the treatment of acute angle-closure glaucoma (AACG)?

Updated: Jun 20, 2019
  • Author: Albert P Lin, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

If the angle continues to be narrow and occludable after laser iridotomy and iridoplasty, especially in an older patient, cataract surgery is indicated to remove the cataract and its mass effect on the angle. If the patient has both a narrow occludable angle and a visually significant cataract (blurry vision due to cataract), cataract surgery is the treatment of choice. It opens the angle and improves vision. [17] Even without significant cataract, effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE) study, conducted in Asia, showed that clear lens extraction may be more efficacious and cost effective than laser iridotomy. The authors suggested that the crystalline lens may play a larger role in the mechanism of angle closure than previously thought and that early lens extraction can be considered as an option for first-line treatment. [18]


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