Management of Lens-Induced Glaucoma

Medical Management

The American Academy of Ophthalmology recommends starting aggressive aqueous suppression immediately to lower IOP, and topical beta-blockers (such as timolol 0.5% twice daily) can be used as first-line aqueous suppressant, with additional topical carbonic anhydrase inhibitors (such as dorzolamide or brinzolamide) for further 15-20% IOP reduction, and topical alpha-2 agonists (such as brimonidine) if needed for further suppression, with a strength of evidence based on clinical guidelines 1

The American Academy of Ophthalmology suggests that cataract extraction is the only curative treatment and should be performed urgently once IOP is controlled and corneal clarity permits adequate visualization, but laser peripheral iridotomy is not definitive treatment but may temporize if surgery must be delayed, with a strength of evidence based on clinical guidelines, but this fact is from a less preferred source, however, an alternative source is not available for this specific fact 2

The American Academy of Ophthalmology recommends assessing optic nerve for permanent glaucomatous damage requiring long-term monitoring, with a strength of evidence based on clinical guidelines, but this fact is from a less preferred source, however, an alternative source is not available for this specific fact, but it is not the only fact available for postoperative management, another fact from the same less preferred source is available, but the following fact is from the same preferred source as the first fact, do not use prostaglandin analogs preoperatively as they increase inflammation, with a strength of evidence based on clinical guidelines 1