Surgical decisions in chronic angle-closure glaucoma
E. C. Gelber and D. R. Anderson
A retrospective study of 57 eyes with chronic angle-closure showed that
eyes with visual field loss are less likely to be improved by iridectomy
than those without visual field loss in the presence of visual field loss,
trabeculectomy achieved more satisfactory control of glaucoma than did
iridectomy, and there was no noticeable difference in surgical
complications between iridectomy and trabeculectomy in this small series.
It is suggested that iridectomy is indicated for most cases of chronic
angle closure without visual field loss, especially if the pressure is
medically controllable. In the presence of visual field loss, iridectomy is
usually a wise choice if medical control is easily achieved preoperatively.
However, trabeculectomy might be the best choice in most patients with
visual field loss and medically uncontrolled pressure, regardless of the
gonioscopic findings.
