Clear lens extraction in angle-closure glaucoma patients

To describe the results of 5 consecutive cases of clear lens extraction in angle closure patients for the treatment of elevated intraocular pressure (IOP).

Retrospective observational case series. All angle closure patients were on two or more topical glaucoma medications and had prior laser iridotomy. Eyes underwent clear lens extraction by phacoemulsification with intraocular lens implantation.

All five patients in this case series carried the diagnosis of angle-closure glaucoma and had uncontrolled IOP prior to surgery despite topical medications. After clear lens extraction three of the cases had good IOP control (IOP<22mmHg) without the need for topical medications. In one case the IOP was better controlled after surgery, however, topical medications were required. The desired IOP was not met in one case despite restarting maximum topical therapy.

This case series suggests that there may be a role for therapeutic clear lens extraction in select cases of angle-closure glaucoma.