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1 General aspects (0)   1.1 Epidemiology (8)   1.2 Population genetics (2)   1.3 Pathogenesis (0)   1.4 Quality of life (17)   1.5 Glaucomas as cause of blindness (6)   1.6 Prevention and screening (17) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (13)   2.2 Cornea (27)   2.3 Sclera (13)   2.4 Anterior chamber angle (3)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (11)     2.5.2 Schlemms canal (4)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (2)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (6)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (3)   2.9 Ciliary body (0)   2.10 Lens (2)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (8)   2.13 Retina and retinal nerve fibre layer (18)   2.14 Optic disc (25)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (6)   2.17 Stem cells (3)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (0)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (21)   3.5 Molecular biology incl. 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Filtering surgery (0)     12.8.1 Without tube implant (8)     12.8.2 With tube implant or other drainage devices (61)     12.8.3 Non-perforating (8)     12.8.4 Using laser (0)     12.8.5 Other (1)     12.8.10 Woundhealing antifibrosis (20)     12.8.11 Complications, endophthalmitis (13)   12.9 Trabeculotomy, goniotomy (39)   12.10 Cyclodestruction (16)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (5)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (24)   12.15 Capsulotomy (0)   12.16 Vitrectomy (3)   12.17 Anesthesia (1)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (11)   13.2 Outcome (0)     13.2.1 IOP (3)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (4) 15 Miscellaneous (43)

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Abstract #90883 Published in IGR 21-4

The role of lens extraction in glaucoma management

Tsui JL; Chan NC; Tham CC
Annals of translational medicine 2020; 8: 1550

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Cataract extraction has become a much safer procedure with the development of phacoemulsification, extending its application in ocular conditions such as glaucoma for better disease control. This review aims at summarizing the effect of lens extraction with or without combined glaucoma surgeries in different types of glaucoma and describing the intraoperative techniques and changes of glaucoma care postoperatively. A comprehensive literature search was performed through Medline and PubMed, and 67 studies were selected for this review. In primary angle closure (PAC) diseases, studies have revealed significant intraocular pressure (IOP) and medication requirement reduction after lens extraction. Fewer studies described its application in primary open angle glaucoma (POAG) and ocular hypertension (OHT), but literature available suggests that it can also lead to better disease control. Likewise, lower postoperative IOP and pressure fluctuations have been shown in normal tension glaucoma (NTG). Advanced glaucoma, shallow anterior chamber and pseudoexfoliation glaucoma (PXG) are three difficult scenarios that are commonly encountered in cataract operations. Special techniques in preventing complications such as wipe out phenomenon are depicted. Goniosynechialysis, endoscopic cyclophotocoagulation and trabecular microbypass stents are a few of the popular choices of glaucoma procedures that can be performed concomitantly with phacoemulsification but evidence of their efficacy needs to be further verified. Cataract operation can improve visual field and retinal nerve fiber layer examination parameters and it is advised to set new baselines after the surgery for subsequent progression monitoring. Clearance of an optically significant cataract results in better quality of life, and with detailed and thorough explanation of the indications, expectations and risks of the surgery, cataract extraction could be considered even in cases of advanced glaucoma.

Full article

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Classification:

12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)

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