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Type: Journal article
Title: Killing two birds with one stone: the potential effect of cataract surgery on the incidence of primary angle-closure glaucoma in a high-risk population
Author: Chan, W.
Garcia, J.
Newland, H.
Muecke, J.
McGovern, S.
Selva-Nayagam, D.
Aung, T.
Casson, R.
Citation: Clinical and Experimental Ophthalmology, 2012; 40(4):128-134
Publisher: Blackwell Publishing Asia
Issue Date: 2012
ISSN: 1442-6404
Statement of
WengOnn Chan, José A García, Henry S Newland, James Muecke, Stephen McGovern, Dinesh Selva, Tin Aung, and Robert J Casson
Abstract: <h4>Background</h4>To estimate the proportion of cataract surgery performed at various visual acuity and lens opacity thresholds that would coincidentally treat early angle-closure disease, and to estimate the effect of this surgery on the incidence of primary angle-closure glaucoma.<h4>Design</h4>Cross-sectional, population-based survey in Meiktila, Myanmar.<h4>Participants</h4>Total of 2076 inhabitants, 40 years of age and over were included.<h4>Methods</h4>Eyes with cataract-induced visual impairment, and primary angle-closure disease were identified. Analyses were stratified by various pinhole-corrected visual acuity and Lens Opacity Classification System III scores thresholds.<h4>Main outcome measures</h4>The dual role of cataract surgery in primary cataract treatment and primary angle-closure glaucoma prevention was estimated.<h4>Results</h4>Of 4153 eyes available for analysis, 261 eyes were either primary angle-closure suspect or primary angle closure; 975 eyes had a visual acuity of <6/18 and Lens Opacity Classification System III score ≥ 3 on the nuclear or cortical scales. Of these, 86 eyes had either primary angle-closure suspect or primary angle closure. If cataract surgery were performed on all 975 eyes, this would potentially prevent up to 86 cases of primary angle-closure glaucoma in this population; 8.82% (95% confidence interval 7.12-10.78%) of the cataract surgery would address the cataract and prevent primary angle-closure glaucoma. This would achieve a 38.46% (95% confidence interval 20.23-59.43%) relative reduction in the incidence of primary angle-closure glaucoma in the adult population.<h4>Conclusion</h4>In populations with a high prevalence of both visually significant cataract and angle-closure disease, quality cataract extraction can serve a dual role of visual restoration and reducing the incidence of angle-closure disease in the population: killing two birds with one stone.
Keywords: angle-closure glaucoma
blindness prevention
cataract surgery
Rights: © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
DOI: 10.1111/j.1442-9071.2011.02607.x
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Opthalmology & Visual Sciences publications

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