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A brief note on bilateral aqueous misdirection after routine cataract surgery in angle closure.

Vanita Pathak-Ray

The ‘Effectiveness of Early lens Extraction for the treatment of Primary Angle-Closure Glaucoma’ (EAGLE) study reported its findings in 2016 and recommended Clear Lens Extraction (CLE) over Laser Peripheral Iridotomy (LPI) in angle closure disease. Worldwide, anterior segment surgeons have been giving it due consideration, even if it may not have been readily adopted universally. However, when cataract is present in such eyes, then most surgeons do not seem to have reservations about performing lens surgery alone even though cataract surgery in angle closure eyes comes with a slight increased risk of aqueous misdirection. Furthermore, several authors have stated that its occurrence in one eye, increases the risk of a similar episode post-surgery in the fellow eye.