Clear Lens Extraction in Primary Angle-closure Disease—Pros and Cons

Cataract extraction for management of primary angle-closure disease has been successfully practiced for many years. However, the extraction of a clear lens for glaucoma management, when visual symptoms are minimal, is a controversial subject. A few studies have reported on the outcomes of clear lens extraction without resorting to conventional methods, such as drugs and lasers. Others have compared clear lens extraction with trabeculectomy or iridotomy. Most have reported successful outcomes with this surgical modality, in terms of intraocular pressure control, reduction in the number of glaucoma medications, opening of the anterior chamber angle, visual gain, and improvement in quality of life. Unfortunately, the studies on clear lens extraction are hampered by both positive and negative aspects in their execution. This review was undertaken to debate the points presented in the studies in order to have a better understanding of the advantages and disadvantages of clear lens extraction in primary angle-closure disease.