PT  - JOURNAL ARTICLE
AU  - G S W Tan
AU  - S-T Hoh
AU  - R Husain
AU  - G Gazzard
AU  - F T S Oen
AU  - S K L Seah
AU  - T Aung
TI  - Visual acuity after acute primary angle closure and considerations for primary lens extraction
AID  - 10.1136/bjo.2005.077115
DP  - 2006 Jan 01
TA  - British Journal of Ophthalmology
PG  - 14--16
VI  - 90
IP  - 1
4099  - http://bjo.bmj.com/content/90/1/14.short
4100  - http://bjo.bmj.com/content/90/1/14.full
SO  - Br J Ophthalmol2006 Jan 01; 90
AB  - Background/aim: Primary lens extraction has been advocated for acute primary angle closure (APAC), but it is not known if this is warranted in all cases. The aim of this study was to investigate the visual acuity (VA) of APAC eyes shortly after resolution of the acute episode in order to assess the appropriateness of performing such surgery in this condition. Methods: This was a prospective observational case series. As part of a randomised controlled trial comparing phacoemulsification and laser iridotomy, 135 consecutive APAC subjects over a 2 year period underwent subjective refraction and measurement of Snellen VA once the acute episode had resolved with reduction of intraocular pressure (IOP) and improved corneal clarity. Results: Subjects were predominantly Chinese (95.6%) and female (79.3%), with a mean age of 63.6 (SD 9.6) years. When assessed 1.7 (2.7) days after presentation, the majority of APAC cases (50.4%) had good VA (6/12 or better), with more than a quarter of cases having VA of 6/7.5 or better. Poor VA was associated with duration of symptoms (p = 0.04, OR = 4.1, 95% CI 1.1 to 15.7) and time taken to resolution of APAC (p = 0.04, OR = 2.2, 95% CI 1.02 to 4.6), but not with sex (p = 0.31), age (p = 0.26), duration from presentation to measurement of visual acuity (p = 0.53), or presenting IOP (p = 0.73). Conclusion: Within days after APAC, more than half of APAC affected eyes had good VA (6/12 or better). The role of lens extraction in the management of APAC warrants further debate, especially for eyes with good VA.