Abstract
Primary angle-closure suspects are individuals with 180° or more contact between the iris and trabecular meshwork, normal intraocular pressure, no evidence of peripheral anterior synechiae (iris adhering to the trabecular meshwork), and a healthy optic nerve. These individuals might develop peripheral anterior synechiae and increased intraocular pressure that damages their optic nerve, a condition known as primary angle-closure glaucoma. Although less common than primary open-angle glaucoma, primary angle-closure glaucoma is more visually destructive. There is good clinical evidence to guide the management of primary angle closure and primary angle-closure glaucoma, either with cataract extraction or laser peripheral iridotomy, but our knowledge regarding the management of primary-angle closure suspects is inadequate. 1 Azuara-Blanco A Burr J Ramsay C et al. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016; 388: 1389-1397 Summary Full Text Full Text PDF PubMed Scopus (273) Google Scholar Laser peripheral iridotomy for the prevention of angle closure: a single-centre, randomised controlled trialIncidence of angle-closure disease was very low among individuals classified as primary angle closure suspects identified through community-based screening. Laser peripheral iridotomy had a modest, albeit significant, prophylactic effect. In view of the low incidence rate of outcomes that have no immediate threat to vision, the benefit of prophylactic laser peripheral iridotomy is limited; therefore, widespread prophylactic laser peripheral iridotomy for primary angle-closure suspects is not recommended. Full-Text PDF
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