An Overview of Treatment Methods for Primary Angle Closure

Area of Science:

• Ophthalmology
• Medical Science

Background:

• Glaucoma is a significant cause of global blindness, with primary angle closure glaucoma (PACG) accounting for 25% of cases.
• PACG prevalence is highest in Asia due to anatomical variations predisposing certain populations, including Inuit and other Asian ethnicities.
• Current management strategies for PACG involve medical, laser, and surgical interventions.

Purpose of the Study:

• To delineate the established treatment protocols for primary angle closure.
• To review the spectrum of therapeutic options for PACG.

Main Methods:

• Literature review of current treatment guidelines for primary angle closure.
• Analysis of established and alternative treatment modalities.

Main Results:

• The standard initial treatment for primary angle closure involves lowering intraocular pressure with medications and performing laser iridotomy.
• Additional therapeutic options include laser iridoplasty, goniosynechiolysis, diode cyclophotocoagulation, and filtering surgery.
• Cataract surgery is highlighted as a particularly effective treatment and preventative measure for angle closure.

Conclusions:

• Primary angle closure arises from diverse anatomical variations.
• Laser iridotomy is not the only treatment; cataract surgery offers significant benefits for treatment and prevention.
• Refractory cases may require trabeculectomy or shunt implants, though these are typically reserved for later stages.