OBJECTIVES: Worldwide, glaucoma is the second highest cause of blindness. Surgery is the treatment of choice when medications fail to control intraocular pressure (IOP). This systematic literature review and meta-analysis aimed to compare efficacy and safety of the common surgical options available for primary angle closure glaucoma (PACG). METHODS: Studies with PACG patients who underwent trabeculectomy, phacotrabeculectomy or phacoemulsification were screened and included from electronic databases. The outcomes compared were IOP (24 months), postoperative angle opening distance (AOD), postoperative trabecular-ciliary process distance, postoperative anterior chamber depth (ACD), synechial angle closure all at 1 year, best corrected visual acuity (BCVA) at 1 year and 2 years, and intra- and post-operative complications of the surgery like worse logarithmic minimal angle resolution BCVA, progression of glaucomatous optic neuropathy, progression of glaucomatous visual field at 2 years. Critical appraisal of studies was carried out using Cochrane’s Risk of Bias tool. Meta-analysis of clinical trials was conducted using RevMan v5.1, through pooling of medically controlled and uncontrolled glaucoma patients where available. RESULTS: Of the 704 studies that were screened, five randomised clinical trials were included. Pooled analysis of two studies showed IOP at 24 months was better controlled by phacotrabeculectomy (mean difference 1.46 [95%CI 0.24,2.67]). Post-operative AOD and ACD results favoured phacoemulsification (mean difference 123.60 [95%CI 51.46,195.74] and 230.60 [95%CI 106.30,354.90] respectively). The post-operative complications showed risk ratio of 0.07 (95%CI 0.01,0.34) showing fewer complications in phacoemulsification patients. The remaining outcomes showed no significant results. Phacoemulsification had significantly lesser complications than trabeculectomy, with risk ratio of 0.08 (95%CI 0.01,0.60). The analyses of the observational and economic studies are being carried out, the results of which will be included in the poster. CONCLUSIONS: The results show that while phacotrabeculectomy has better IOP control than phacoemulsification, the latter has higher safety than both phacotrabeculectomy and trabeculectomy.