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dc.contributor.authorTAGS Study Group
dc.contributor.authorKing, Anthony J
dc.contributor.authorHudson, Jemma
dc.contributor.authorFernie, Gordon
dc.contributor.authorKernohan, Ashleigh
dc.contributor.authorAzuara-Blanco, Augusto
dc.contributor.authorBurr, Jennifer
dc.contributor.authorHomer, Tara
dc.contributor.authorShabaninejad, Hosein
dc.contributor.authorSparrow, John M
dc.contributor.authorGarway-Heath, David
dc.contributor.authorBarton, Keith
dc.contributor.authorNorrie, John
dc.contributor.authorMcDonald, Alison
dc.contributor.authorVale, Luke
dc.contributor.authorMacLennan, Graeme
dc.contributor.authorKousha, Obaid
dc.identifier.citationTAGS Study Group , King , A J , Hudson , J , Fernie , G , Kernohan , A , Azuara-Blanco , A , Burr , J , Homer , T , Shabaninejad , H , Sparrow , J M , Garway-Heath , D , Barton , K , Norrie , J , McDonald , A , Vale , L , MacLennan , G & Kousha , O 2021 , ' Primary trabeculectomy for advanced glaucoma : pragmatic multicentre randomised controlled trial (TAGS) ' , BMJ , vol. 373 , n1014 .
dc.identifier.otherPURE: 274210727
dc.identifier.otherPURE UUID: 9ffa393d-9cc6-4f69-80a2-1e8a134a058a
dc.identifier.otherJisc: dd774d0b02534df98e0eabb5d243d03c
dc.identifier.otherpublisher-id: kina063068
dc.identifier.otherORCID: /0000-0002-9478-738X/work/93894252
dc.identifier.otherScopus: 85105840740
dc.identifier.otherWOS: 000651243600001
dc.descriptionFunding: The project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA) Programme (project number 12/35/38). The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.en
dc.description.abstractObjective : To determine whether primary trabeculectomy or primary medical treatment produces better outcomes in term of quality of life, clinical effectiveness, and safety in patients presenting with advanced glaucoma.  Design : Pragmatic multicentre randomised controlled trial.  Setting : 27 secondary care glaucoma departments in the UK.  Participants : 453 adults presenting with newly diagnosed advanced open angle glaucoma in at least one eye (Hodapp classification) between 3 June 2014 and 31 May 2017.  Interventions : Mitomycin C augmented trabeculectomy (n=227) and escalating medical management with intraocular pressure reducing drops (n=226).  Main outcome measures : Primary outcome: vision specific quality of life measured with Visual Function Questionnaire-25 (VFQ-25) at 24 months. Secondary outcomes: general health status, glaucoma related quality of life, clinical effectiveness (intraocular pressure, visual field, visual acuity), and safety.  Results : At 24 months, the mean VFQ-25 scores in the trabeculectomy and medical arms were 85.4 (SD 13.8) and 84.5 (16.3), respectively (mean difference 1.06, 95% confidence interval −1.32 to 3.43; P=0.38). Mean intraocular pressure was 12.4 (SD 4.7) mm Hg for trabeculectomy and 15.1 (4.8) mm Hg for medical management (mean difference −2.8 (−3.8 to −1.7) mm Hg; P<0.001). Adverse events occurred in 88 (39%) patients in the trabeculectomy arm and 100 (44%) in the medical management arm (relative risk 0.88, 95% confidence interval 0.66 to 1.17; P=0.37). Serious side effects were rare. Conclusion : Primary trabeculectomy had similar quality of life and safety outcomes and achieved a lower intraocular pressure compared with primary medication.
dc.rightsCopyright © 2021 the Author(s). This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.en
dc.subjectRD Surgeryen
dc.subjectRE Ophthalmologyen
dc.titlePrimary trabeculectomy for advanced glaucoma : pragmatic multicentre randomised controlled trial (TAGS)en
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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