title: Killing two birds with one stone: the potential effect of cataract surgery on the incidence of primary angle-closure glaucoma in a high-risk population.
abstract: BACKGROUND
  To estimate the proportion of cataract surgery performed at various visual acuity and lens opacity thresholds that would coincidentally treat early angle-closure disease, and to estimate the effect of this surgery on the incidence of primary angle-closure glaucoma.
  
  
  METHODS
  Cross-sectional, population-based survey in Meiktila, Myanmar.
  
  
  METHODS
  Total of 2076 inhabitants, 40 years of age and over were included.
  
  
  METHODS
  Eyes with cataract-induced visual impairment, and primary angle-closure disease were identified. Analyses were stratified by various pinhole-corrected visual acuity and Lens Opacity Classification System III scores thresholds.
  
  
  METHODS
  The dual role of cataract surgery in primary cataract treatment and primary angle-closure glaucoma prevention was estimated.
  
  
  RESULTS
  Of 4153 eyes available for analysis, 261 eyes were either primary angle-closure suspect or primary angle closure; 975 eyes had a visual acuity of <6/18 and Lens Opacity Classification System III score ≥ 3 on the nuclear or cortical scales. Of these, 86 eyes had either primary angle-closure suspect or primary angle closure. If cataract surgery were performed on all 975 eyes, this would potentially prevent up to 86 cases of primary angle-closure glaucoma in this population; 8.82% (95% confidence interval 7.12-10.78%) of the cataract surgery would address the cataract and prevent primary angle-closure glaucoma. This would achieve a 38.46% (95% confidence interval 20.23-59.43%) relative reduction in the incidence of primary angle-closure glaucoma in the adult population.
  
  
  CONCLUSIONS
  In populations with a high prevalence of both visually significant cataract and angle-closure disease, quality cataract extraction can serve a dual role of visual restoration and reducing the incidence of angle-closure disease in the population: killing two birds with one stone.
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia. onn912@gmail.com
authors.forename: WengOnn
authors.initials: W
authors.lastname: Chan
authors.forename: José A
authors.initials: JA
authors.lastname: García
authors.forename: Henry S
authors.initials: HS
authors.lastname: Newland
authors.forename: James
authors.initials: J
authors.lastname: Muecke
authors.forename: Stephen
authors.initials: S
authors.lastname: McGovern
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Casson
mesh_terms: D000328:Adult; D001766:Blindness / Q000453:epidemiology; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D015812:Glaucoma, Angle-Closure / Q000453:epidemiology* / Q000517:prevention & control; D006068:Gonioscopy; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular; D002052:Myanmar / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D014065:Tonometry, Ocular; D015354:Vision, Low / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology