With the advancement of technology and the development of phacoemulsification, lens extraction can now be performed through smaller corneal incisions with minimal conjunctival manipulation and intraoperative intraocular pressure fluctuations. For different stages of Primary Angle Closure diseases, phacoemulsification alone or combined with glaucoma procedures are important surgical treatment options in the control of intraocular pressure and disease progression. This chapter will illustrate the algorithm in the choice of surgery in different scenarios with the display of recent evidence. We will also discuss the potential perioperative risk and complications aside from its preventive measures in this group of patients.