Current approaches to the management of acute primary angle closure.
OBJECTIVE
Recent advances in the management of acute primary angle closure include argon laser peripheral iridoplasty, immediate anterior chamber paracentesis, and cataract or lens extraction by phacoemulsification. This review summarizes current thoughts on the role of these treatment modalities.


RESULTS
Argon laser peripheral iridoplasty has been shown to be superior to treatments using combined topical and systemic medications in controlling intraocular pressure in acute primary angle closure. Immediate paracentesis has been shown to be very effective for aborting the condition. This is a good alternative for suitable cases and especially in settings in which laser equipment is not readily available. Cataract or lens extraction by phacoemulsification appears to be promising in preventing progression to chronic angle closure glaucoma after acute primary angle closure.


CONCLUSIONS
Surgical trials are underway to examine the role of cataract/lens extraction in post-acute primary angle closure. This technique has the potential to prevent recurrence of the condition and progression to chronic angle closure glaucoma. With existing and upcoming new data on managing acute primary angle closure, it is hopeful that a more optimal treatment algorithm will be established soon.
Lam
Dennis S C
DS
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong , People's Republic of China.
Tham
Clement C Y
CC
Lai
Jimmy S M
JS
Leung
Dexter Y L
DY
D000208:Acute Disease; D002386:Cataract / Q000150:complications; D018450:Disease Progression; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D019152:Paracentesis / Q000379:methods*; D018918:Phacoemulsification / Q000379:methods; D016896:Treatment Outcome