Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma

Costa, Vital Paulino; Leung, Christopher Kin Ying; Kook, Michael S.; Lin, Shan; Al-Aswad, Lama A.; Araie, Makoto; Baudouin, Christophe; Coupal, Dustin; Fechtner, Robert D.; Khaw, Peng Tee; Khaderi, Khizer R.; Khawaja, Anthony P.; Mattox, Cynthia; Miller-Ellis, Eydie; Nagori, Saya; Olivier, Mildred M.G.; Pfeiffer, Norbert; Serle, Janet B.; Stalmans, Ingeborg; Varma, Devesh

doi:10.1016/j.survophthal.2020.04.003

Cited by 20 publications

(27 citation statements)

References 97 publications

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“…Table 2 presents the key preoperative, intraoperative, and postoperative factors requiring management in patients undergoing phaco with previous AAC [10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Lessons From Management: Perioperative Phacoemulsification Planning Following Resolution of Acute Angle Closure

Lee¹,

Lau²,

Wong³

et al. 2021

Cureus

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Patients with loose zonular apparatus after acute angle closure may require phacoemulsification cataract surgery. The authors' experience from management of such patients provides excellent instruction on the surgical intervention for their cataracts. This is because patients who have recovered from acute angle closure glaucoma may not have evident zonular laxity preoperatively, as the iris may be taut secondary to the effects of associated ischaemia. If the surgeon's preoperative planning is directed to the possibility of loose zonular apparatus, then appropriate preoperative, intraoperative, and postoperative planning and management can be effected. This may permit preoperative patient counselling regarding the potentially increased complexity of the case. Intraoperatively, deliberately gentle capsulorrhexis, the use of iris hooks or a pupil expander to dilate the pupil, iris hooks to support the capsular bag, and the employment of a capsular tension ring may be helpful. Postoperatively, due to the previous ocular ischaemia, intraocular pressure elevation may ensue, and should be actively managed. The authors provide a summary of factors that require consideration in patients undergoing cataract surgery following acute angle closure.

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“…Table 2 presents the key preoperative, intraoperative, and postoperative factors requiring management in patients undergoing phaco with previous AAC [10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Lessons From Management: Perioperative Phacoemulsification Planning Following Resolution of Acute Angle Closure

Lee¹,

Lau²,

Wong³

et al. 2021

Cureus

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“…Cataract extraction has been proven to be effective in intraocular pressure control, particularly in eyes with narrow angles by widening the angle. [31][32][33][34][35] Similarly, increased CSR could reduce the prevalence of PACG, especially in people older than 70 years. 36 In addition to the above anatomical reasons, access to cataract services may serve as an opportunity for the detection of diseases such as glaucoma during preoperative screening.…”

Section: Open Accessmentioning

confidence: 99%

Time trends, associations and prevalence of blindness and vision loss due to glaucoma: an analysis of observational data from the Global Burden of Disease Study 2017

et al. 2022

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ObjectiveTo estimate global prevalence of blindness and vision loss caused by glaucoma, and to evaluate the impact of socioeconomic factors on it.DesignA population-based observational study.SettingThe prevalence of blindness and vision loss due to glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), inequality-adjusted HDI and other socioeconomic data were acquired from international open databases.Main outcome measuresThe prevalence of blindness and vision loss due to glaucoma by age, gender, subregion and Socio-Demographic Index (SDI) levels. Multiple linear regression analysis was performed to explore the associations between the prevalence and socioeconomic indicators.ResultsThe overall age-standardised prevalence of blindness and vision loss due to glaucoma worldwide was 81.5 per 100 000 in 1990 and 75.6 per 100 000 in 2017. In 2017, men had a higher age-standardised prevalence than women (6.07% vs 5.42%), and the worldwide prevalence increased with age, from 0.5 per 100 000 in the 45–49 year age group to 112.9 per 100 000 among those 70+. Eastern Mediterranean and African regions had the highest prevalence during the whole period, while the Americas region had the lowest prevalence. The prevalence was highest in low-SDI and low-income regions while lowest in high-SDI and high-income regions over the past 27 years. Multiple linear regression showed cataract surgery rate (β=−0.01, p=0.009), refractive error prevalence (β=−0.03, p=0.024) and expected years of schooling (β= -8.33, p=0.035) were associated with lower prevalence, while gross national income per capita (β=0.002, p<0.001) was associated with higher prevalence.ConclusionsLower socioeconomic levels and worse access to eyecare services are associated with higher prevalence of glaucoma-related blindness and vision loss. These findings provide evidence for policy-makers that investments in these areas may reduce the burden of the leading cause of irreversible blindness.

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“…It takes a long time and a lot of money to train qualified and experienced surgeons to do the surgery. They should master the procedure expertly and possess the ability to deal with all complications timely and properly [ 29 ]. So currently, in developing countries, the role of LPI in the management of PAC eyes is still irreplaceable.…”

Section: Discussionmentioning

confidence: 99%

Biometric indicators of anterior segment parameters before and after laser peripheral iridotomy by swept-source optical coherent tomography

Wang

Zhang

et al. 2022

BMC Ophthalmol

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Background Primary angle closure glaucoma (PACG) is the most common type of glaucoma in China. Laser peripheral iridotomy (LPI) is the primary choice to treat PAC: We aim to evaluate the changes of biometric parameters of anterior segment and to find possible biometric predictors of the effect of laser peripheral iridotomy (LPI) in primary angle closure (PAC) eyes using swept-source optical coherent tomography (OCT). Methods LPI was performed in 52 PAC eyes of 28 participants. The change of intraocular pressure and anterior segment parameters, including angle opening distance (AOD500), AOD500 area, trabecular iris space area (TISA500), TISA500 volume, trabecular iris angle (TIA500), iridotrabecular contact (ITC) index, ITC area, anterior chamber volume (ACV), anterior chamber depth (ACD), lens vault (LV) and lens thickness (LT) before and 1 week after LPI were measured by Tomey CASIA2 anterior segment OCT. We also estimate and analyze potential associated factors possibly affecting the change of anterior chamber parameters. Results No post-laser complications were found. The ACD, LV and LT did not change significantly 1 week after LPI. AOD500, AOD500 area, TISA500, TISA500 volume, TIA500, ACV increased significantly after LPI. There was significant decrease in ITC index and ITC area. LT was positively correlated to the change of ITC index (β = 0.239, *p = 0.045). Conclusions The anterior segment architecture significantly changed after LPI in PAC spectrum eyes. Crystalline lens measurements remained unchanged before and after LPI. AS-OCT can be used to follow anterior chamber parameter changes in PAC spectrum eyes. LT may play a role in the therapeutic effect of LPI.

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Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma

Cited by 20 publications

References 97 publications

Lessons From Management: Perioperative Phacoemulsification Planning Following Resolution of Acute Angle Closure

Lessons From Management: Perioperative Phacoemulsification Planning Following Resolution of Acute Angle Closure

Time trends, associations and prevalence of blindness and vision loss due to glaucoma: an analysis of observational data from the Global Burden of Disease Study 2017

Biometric indicators of anterior segment parameters before and after laser peripheral iridotomy by swept-source optical coherent tomography

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