Long-term outcomes following lens extraction surgery in acute primary angle closure

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Acute primary angle closure (APAC) is a serious ophthalmic condition requiring prompt intervention.
• Lens extraction (LE) is a common surgical approach for APAC, but its long-term efficacy requires further investigation.
• Identifying risk factors for glaucomatous optic neuropathy (GON) is crucial for managing APAC patients post-surgery.

Purpose of the Study:

• To evaluate the long-term visual outcomes of patients with APAC following lens extraction (LE) surgery.
• To identify predictors of blindness and risk factors associated with visual deterioration in this patient cohort.
• To assess the progression of glaucomatous optic neuropathy (GON) after LE surgery in APAC eyes.

Main Methods:

• A longitudinal observational study was conducted on APAC patients who underwent LE surgery.
• Detailed ophthalmic examinations and medical histories were collected for long-term follow-up.
• Logistic and linear regression analyses were used to identify risk factors for blindness and visual outcomes.

Main Results:

• After a mean follow-up of 6.7 years, 23.7% of affected eyes had GON, and 28.9% were blind.
• Worse visual acuity at the time of the APAC attack and early postoperatively were significant risk factors for blindness.
• Longer duration of elevated intraocular pressure and poorer early postoperative visual acuity correlated with worse long-term visual outcomes.

Conclusions:

• Lens extraction surgery alone may not be sufficient to prevent long-term visual function decline in some APAC patients.
• Lifelong monitoring is essential for APAC patients post-LE surgery to manage intraocular pressure and detect progression.
• Regular re-evaluation of target intraocular pressure and progression rates is necessary during follow-up care.