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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Light rays enter the eye through the cornea, a transparent dome-shaped tissue that is the eye's outermost layer. The cornea bends or refracts, light rays traveling to the pupil. The shape of the cornea determines how much of the light is bent and whether the image will be focused correctly on the retina at the back of the eye. Once the light has passed through both refraction layers, it converges into a single focal point onto a small area. This is where photoreceptors start transforming...
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Related Experiment Video

Updated: Nov 11, 2025

Iris Fixation via External Pentagram Suturing
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Lens extraction for chronic angle-closure glaucoma.

Ariel Yuhan Ong1, Sueko M Ng2, S Swaroop Vedula3

  • 1Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

The Cochrane Database of Systematic Reviews
|March 24, 2021
PubMed
Summary
This summary is machine-generated.

Lens extraction is more effective than laser peripheral iridotomy for primary angle-closure glaucoma (PACG), reducing visual field loss and medication needs. Combined procedures offer no additional benefit over lens extraction alone.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Interventions

Background:

  • Primary angle-closure glaucoma (PACG) involves elevated intraocular pressure (IOP) due to aqueous outflow obstruction, often caused by relative pupillary block.
  • Lens extraction is increasingly recognized for its potential to alleviate pupillary block and improve IOP control in PACG.
  • Comparing lens extraction with other treatments is crucial for informed clinical decision-making in managing chronic PACG.

Purpose of the Study:

  • To evaluate the effectiveness of lens extraction compared to alternative interventions for chronic primary angle-closure glaucoma.
  • To assess outcomes in patients without prior acute angle-closure attacks.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (CENTRAL, MEDLINE, Embase) and trial registers up to December 2019.
  • Inclusion criteria focused on RCTs comparing lens extraction with other treatments for chronic PACG.
  • Data extraction and analysis followed standard Cochrane methodology; meta-analysis was not possible due to heterogeneity in follow-up periods and data limitations.

Main Results:

  • Moderate certainty evidence indicates lens extraction (phacoemulsification) is superior to laser peripheral iridotomy (LPI) in reducing visual field loss progression and the need for IOP-lowering medications.
  • Phacoemulsification showed improved gonioscopic findings compared to LPI, but no significant differences in quality of life or visual acuity were observed.
  • Comparisons with phaco-viscogonioplasty and phaco-goniosynechialysis suggest limited additional benefit from combined procedures, with mixed evidence on IOP and medication requirements.

Conclusions:

  • Lens extraction demonstrates an advantage over LPI for chronic PACG with clear lenses, supporting its role in management.
  • Combining phacoemulsification with viscogonioplasty or goniosynechialysis does not appear to offer additional benefits over phacoemulsification alone.
  • Insufficient evidence exists for comparing phacoemulsification with trabeculectomy; combining them may increase complications without clear advantages.