Surgical management of chronic angle-closure glaucoma

Authors

  • Yolanda YY Kwong Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
  • Clement CY Tham Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
  • Jimmy SM Lai Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
  • SW Lam Einhorn Clinical Center, New York Eye and Ear Infirmary, New York, New York, USA.
  • Jonathan CH Chan Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
  • Robert Ritch Einhorn Clinical Center, New York Eye and Ear Infirmary, New York, New York, USA.
  • Dennis SC Lam Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.

Abstract

Chronic angle-closure glaucoma is a major cause of blindness, particularly in Asia. The goals of man- agement are to prevent both progression of anatomic angle-closure and progression of glaucomatous optic neuropathy, the latter by controlling intraocular pres- sure. Laser iridotomy to eliminate pupillary block is the definitive initial treatment and laser peripheral iridoplasty is the second-line treatment to eliminate any residual appositional angle-closure.

Topical medications are used if the intraocular pres- sure remains uncontrolled. If the target pressure is not reached with maximally tolerated medications, surgery is indicated. Options include trabeculectomy with or without lens extraction, lens extraction alone, combined phacoemulsification and non-penetrating deep sclerectomy, goniosynechialysis with or with- out lens extraction, cyclodestructive procedures, and glaucoma drainage implants.

Recently, lens extraction has been actively studied and appears to be promising as an effective treatment, since it reverses the anatomical predisposition to angle-closure. More work needs to be done to define its role in the management of chronic angle-closure glaucoma.

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Published

2007-12-01

How to Cite

1.
Kwong YY, Tham CC, Lai JS, Lam S, Chan JC, Ritch R, Lam DS. Surgical management of chronic angle-closure glaucoma. Hong Kong J Ophthalmol [Internet]. 2007Dec.1 [cited 2022May28];11(1):23-9. Available from: https://hkjo.hk/index.php/hkjo/article/view/69

Issue

Section

Review Articles