Twenty-three eyes of 22 consecutive patients with primary chronic angle-closure glaucoma (PCACG) undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation were studied prospectively to assess the effect of ECCE on intraocular pressure (IOP) control. For comparison, a group of 21 eyes with open angle glaucoma (OAG) which had undergone ECCE were reviewed retrospectively. The PCACG group had a low incidence of acute post-operative IOP elevations (9%), and long-term the majority (65%) achieved an IOP less than 21 mmHg off all glaucoma medications. In the OAG group the IOP control was largely unaffected. We recommend that eyes with cataract and PCACG should be considered for ECCE as a first procedure rather than combined cataract and filtering surgery.