Surgical decisions in chronic angle-closure glaucoma.

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.