November 16, 2013
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Surgeon suggests phaco alone in mild cases of PACG

NEW ORLEANS – In cases of primary angle closure glaucoma, phacoemulsification alone may be considered in eyes with mild degree of angle closure, one surgeon told colleagues here.

“I ask myself: Is there a significant cataract? If yes, I consider phaco,” Tin Aung FRCS, PhD, told colleagues at Glaucoma Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Basing his presentation on a review of peer-reviewed published literature, Aung said that phacoemulsification alone is generally effective in improving IOP control. Adding trabeculectomy lowers IOP and results in the need for fewer glaucoma drugs after surgery, he said; however, there are more postoperative complications. Phacoemulsification alone is a feasible option for control of IOP in eyes with medically controlled PACG, Aung said. Trabeculectomy can be added in more advanced cases when patients need further IOP reduction.

Disclosure: Aung has commercial relationships with Alcon, Allergan, Aquesys, Carl Zeiss Meditec, Ellex, Merck, Ocular Therapeutix, Pfizer, Quark and Santen.