CLEAR-LENS EXTRACTION FOR PRIMARY ANGLE CLOSURE DISEASE

Dr Tooba, Dr Iram, Dr Ghuncha, Dr Anwar, Dr Naeem

The lens plays an important role in the development of primary angle closure disease (PACD). This concept was first given by Priestley Smith in 1891.

Conventionally, PACD is managed by pharmacological means or laser procedures. Usually, these two modalities are sufficient to control intra-ocular pressure (IOP). However, ocassionally these techniques are not sufficient to bring IOP down to target pressure levels. In such situations other methods have to be attempted.

Over the years, cataract extraction has become a second-line procedure to bring down IOP in such cases. A number of reports have been published regarding successful outcomes following cataract surgery (ECCE or phacoemulsification) in eyes with PACD. 

However, the new modality of Clear-Lens Extraction (CLE) for managing PACD has become a subject of debate. Unlike cataract surgery this technique involves removal of a clear lens where visual symptoms are minimal. A number of studies such as the landmark EAGLE study and those by Tham, Dada and Man have shown that CLE could be a useful procedure to deal with PACD.

The studies mentioned above have thrown up a lot of positive as well as negative aspects regarding the conduct of the studies themselves and the inferences coming out of them.

In such a scenario we performed a review of CLE in cases of PACD. The article will be published in a forthcoming issue of US Ophthalmic Review. The ahead of publication epub is available at the following link:

https://www.touchophthalmology.com/clear-lens-extraction-in-primary-angle-closure-disease-pros-and-cons/