In a retrospective study, researchers based in Hong Kong compared the 10-year clinical outcomes of eyes with acute primary angle closure (APAC) randomized to receive either early phacoemulsification or laser peripheral iridotomy (LPI). The patients were drawn from a previous randomized, controlled clinical trial.

Nineteen patients in the phaco group and 21 from the LPI group were examined. None of them underwent additional glaucoma procedures, but 15 (71.4%) patients in the LPI group underwent lens extraction before this new assessment.

The phaco group used fewer medications (0.16±0.37 vs 0.76±1.09 bottle per eye), had less extensive anterior synechiae (120.0±116.12 vs 244.3±139.8 degree), and had greater mean Shaffer gonioscopy grading (1.79±0.84 vs. 1.40±0.87) than the LPI group. In the LPI group, 5 eyes had persistent IOP of >21 mmHg at 2 consecutive visits, and 4 eyes had blindness, with BCVA worse than 6/60 and/or central visual field less than 20°, compared to none in the phaco group. There were no significant differences in the mean IOP, BCVA, or the number of eyes with visual field progression. The researchers, who reported their findings in the Journal of Glaucoma, concluded that, at 10 years, APAC eyes that underwent early phacoemulsification required fewer medications and had a lower incidence of IOP elevation and of blindness than APAC eyes that underwent initial LPI.