Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Curr Opin Ophthalmol. 2014 Mar;25(2):89-92. doi: 10.1097/ICU.0000000000000028.
To review the classification of primary angle closure (PAC) and discuss the evidence-based management of each type.
There is limited evidence to support the prophylactic treatment of primary angle closure suspects. Cataract and clear lens extraction may be more effective than traditional therapy in controlling intraocular pressure (IOP) in patients with PAC, primary angle closure glaucoma, and acute angle closure crisis.
Treatment of angle closure depends on the signs of chronic angle damage and glaucomatous optic neuropathy. In the absence of such evidence, serial gonioscopy may be the preferred therapy. If signs or symptoms are present, medical therapy and laser peripheral iridotomy are beneficial. However, recent data suggest that cataract extraction may be more effective at controlling the IOP than laser or incisional glaucoma procedures.
回顾原发性闭角型青光眼（PAC）的分类，并讨论每种类型的循证管理。
目前仅有有限的证据支持对原发性闭角型青光眼疑似患者进行预防性治疗。白内障和晶状体超声乳化术在控制 PAC、原发性闭角型青光眼和急性闭角型青光眼发作患者的眼内压（IOP）方面可能比传统治疗更有效。
闭角型青光眼的治疗取决于慢性房角损伤和青光眼性视神经病变的迹象。在没有这些证据的情况下，连续房角镜检查可能是首选的治疗方法。如果出现体征或症状，药物治疗和激光周边虹膜切开术是有益的。然而，最近的数据表明，白内障摘除术在控制眼压方面可能比激光或手术性青光眼手术更有效。
