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Killing Two Birds with One Stone: The Potential Effect of Cataract Surgery on the Incidence of Primary Angle-Closure Glaucoma Meiktila 1. WengOnn Chan¹ ¹South Australian Institute of Ophthalmology and Discipline of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, Australia Purpose: To estimate the proportion of cataract surgery performed at various visual acuity and lens opacity thresholds that would coincidentally treat early angle-closure disease in a high risk population. Methods: A cross-sectional, population-based survey of inhabitants 40 years of age and over from villages in Meiktila was performed; there were a total of 2076 participants. The number of eyes with cataract-induced visual impairment, primary angle-closure suspect (PACS) status and primary angle-closure (PAC) were identified. Analyses were stratified based on various thresholds of pinhole-corrected visual acuity (VA) and (Lens Opacity Classification System) LOCS III scores. The dual role of cataract surgery in primary cataract treatment and PACG prevention was estimated. Results: A total of 4153 eyes were available for analysis; of these, 261 eyes were either PACS or had PAC. We identified 975 eyes with VA of <6/18 and LOCS III score ≥3 on the nuclear or cortical scales; of these, 86 eyes had either PACS or PAC. If cataract surgery were performed on all 975 eyes, this would potentially prevent 86 cases of PACG in this population; 8.8% of the cataract surgery would address the cataract and prevent PACG. This would achieve a 33% relative reduction in the incidence of PACG in the adult population. Conclusion: In populations with a high prevalence of both visually-significant cataract and angle closure disease, cataract extraction can serve a dual role of visual restoration and reducing the incidence of blinding angle-closure disease in the population: killing two birds with one stone. |
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