Acute angle-closure glaucoma is an ophthalmic emergency with a sudden onset, and the IOP can usually reach 50-70 mmHg (normal value 10-21 mmHg). Acute angle-closure glaucoma is a common condition in ophthalmology, and most patients can be relieved by conventional treatment, but some patients cannot control IOP with medication and laser treatment, and their visual function is at great risk. Due to the high risk of surgery in the high IOP state and the limited capacity of primary care hospitals, patients are referred several times, but the high IOP state continues to remain unrelieved and some patients eventually lose their vision. If timely and effective treatment is available, this group of patients can not only be spared from blindness, but can even obtain better vision than before the onset of the disease. Because of the large number of patients with refractory acute glaucoma referred to our hospital, I proposed a quadruple surgical protocol (i.e., puncture + cataract extraction combined with one-stage IOL implantation + atrial angle separation + pupil reconstruction) based on my previous experience. The IOP was stabilized in a satisfactory range after surgery. In addition, most of the patients have achieved satisfactory postoperative visual acuity, and some of them have recovered visual acuity even higher than that before the glaucoma attack. Compared with the trabeculectomy currently used by most doctors, the quadruple surgery model has the following advantages: 1. The treatment concept of acute angle-closure glaucoma has fundamentally changed, i.e., from the previous concept of simply lowering IOP to the concept of lowering IOP and improving visual acuity at the same time. 2.The atrial angle stenosis is fundamentally lifted, and no acute attack will occur again after surgery. 3.The risk control of surgery in the high IOP state improved the safety of the surgery, and none of the cases experienced fulminant choroidal hemorrhage caused by sudden drop of IOP. Burst choroidal hemorrhage is the biggest risk of acute glaucoma surgery, and once it occurs, vision will be basically lost. 4. The pupil dilatation caused by an acute attack of glaucoma cannot be recovered after the IOP drops, and keeping the pupil dilated for life is the main factor affecting the patient’s long-term vision, and there is no effective method to improve it. The quadruplex surgery cleverly utilizes the patient’s own anterior lens capsule tissue to reconstruct the pupil, significantly reducing the impact of pupillary dilation on long-term vision, with excellent results in many patients. The main difficulties of quadruplex surgery are: 1. The patient’s eye condition is complex, and factors such as acute congestion state, small surgical space, and corneal edema make the surgery operation complicated, thus requiring great surgical skills from the surgeon. 2. The eye with acute attack is very fragile, requiring the surgeon to operate with high stability. 3. The eye with acute attack has poor visual function, and post-bulbar anesthesia may cause the patient to lose light perception. The surgery is performed under superficial anesthesia, i.e., only 3 drops of Benoxyl drops are used, requiring the surgeon to be skilled and the operation time is short to minimize the patient’s discomfort.