Aim: To evaluate the outcome of lens extraction as a management option in primary angle closure disease (PACD) with visually significant cataract.

Methods: Thirty eyes of 30 patients having PACD of different stagesconstituted material for this prospective, non randomized, interventional study. Group A had 15 eyes of Primary Angle closure suspect (PACS), Group B had 8 eyes of Primary Angle closure (PAC) and Group C had 7 eyes of Primary Angle closure Glaucoma (PACG). All cases underwent phacoemulsification with foldable IOL implantationand followed for at least 3 months. Outcome measures included intra ocular pressure (IOP), best corrected visual acuity (BCVA), need for anti glaucoma medication, and gonioscopic appearance. Statistical analyses were performed using SPSS software and epicalc 2000.

Results: Before lens extraction, themean IOP in groups A, B and C was found to be 19.06, 31.25 and 37.14 mm Hg, respectively. After lens extraction, the mean IOP in groups A, B and C was found to be 16.0, 18.25 and 20.57 mm Hg, respectively.Gonioscopy after lens extraction showed that one case (12.5%) in group B and 2 cases (28.57%) in group C had PAS >180 degree; these 3 cases required anti glaucoma medication after lens extraction.

Conclusion: lens extraction in cases of Primary Angle closure Disease should be considered as a treatment option. However, presence of Peripheral Anterior Synechiae more than 180 degree is a limiting factor for adequate control of intra ocular pressure following lens extraction.