Lens Extraction in Primary Angle-Closure Glaucoma Management
Lens Extraction in Primary Angle-Closure Glaucoma Management
The optimal timing of lens extraction after APAC is unknown. While some surgeons advocate primary lens extraction days after the resolution of an APAC episode (to prevent PAS formation), others suggest the optimal timing may be weeks later when intraocular inflammation and corneal clarity have improved. If there are service constraints or limited access to the operating theater, a practical suggestion to perform LPI first may be considered before lens extraction. The combined effect on the corneal endothelium of these two sequential procedures performed, however, needs to be considered.
In the case of chronic PACG, measurement of the IOP, detailed evaluation of angle morphology (particularly the extent of PAS) and degree of glaucomatous optic neuropathy should be documented, along with visual acuity and the presence of visual symptoms. In general, delaying cataract surgery in cases of PACG may result in technically more challenging surgery. In general, a period of approximately 1–2 weeks is a reasonable time frame from presentation to surgery.
Timing of Lens Extraction in Angle-closure Glaucoma
The optimal timing of lens extraction after APAC is unknown. While some surgeons advocate primary lens extraction days after the resolution of an APAC episode (to prevent PAS formation), others suggest the optimal timing may be weeks later when intraocular inflammation and corneal clarity have improved. If there are service constraints or limited access to the operating theater, a practical suggestion to perform LPI first may be considered before lens extraction. The combined effect on the corneal endothelium of these two sequential procedures performed, however, needs to be considered.
In the case of chronic PACG, measurement of the IOP, detailed evaluation of angle morphology (particularly the extent of PAS) and degree of glaucomatous optic neuropathy should be documented, along with visual acuity and the presence of visual symptoms. In general, delaying cataract surgery in cases of PACG may result in technically more challenging surgery. In general, a period of approximately 1–2 weeks is a reasonable time frame from presentation to surgery.