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dc.contributor.authorAzuara-Blanco, Augusto
dc.contributor.authorBurr, Jennifer
dc.contributor.authorRamsay, Craig
dc.contributor.authorCooper, David
dc.contributor.authorFoster, Paul J.
dc.contributor.authorFriedman, David S.
dc.contributor.authorScotland, Graham
dc.contributor.authorJavanbakht, Mehdi
dc.contributor.authorCochrane, Claire
dc.contributor.authorNorrie, John
dc.contributor.authorEAGLE study group
dc.date.accessioned2016-09-30T09:30:15Z
dc.date.available2016-09-30T09:30:15Z
dc.date.issued2016-10-01
dc.identifier.citationAzuara-Blanco , A , Burr , J , Ramsay , C , Cooper , D , Foster , P J , Friedman , D S , Scotland , G , Javanbakht , M , Cochrane , C , Norrie , J & EAGLE study group 2016 , ' Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE) : a randomised controlled trial ' , Lancet , vol. 388 , no. 10052 , pp. 1389-1397 . https://doi.org/10.1016/S0140-6736(16)30956-4en
dc.identifier.issn0140-6736
dc.identifier.otherPURE: 246389135
dc.identifier.otherPURE UUID: 5c8f27b0-649e-45e6-be69-ee1229bd04d4
dc.identifier.otherRIS: urn:4750B6A46BB41D13EE2874879F790525
dc.identifier.otherScopus: 84994876765
dc.identifier.otherORCID: /0000-0002-9478-738X/work/60196179
dc.identifier.otherWOS: 000384404300033
dc.identifier.urihttp://hdl.handle.net/10023/9581
dc.descriptionPJF is supported by salary funding from the National Institute for Health Research (NIHR) through a grant to the Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology. This work is supported by the Medical Research Council (MRC G0701604) and funding is managed by the NIHR (NIHR-EME 09-800-26) on behalf of the MRC–NIHR partnership.en
dc.description.abstractBackground . Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment. Methods . From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment. Eligible patients were aged 50 years or older, did not have cataracts, and had newly diagnosed primary angle closure with intraocular pressure 30 mm Hg or greater or primary angle-closure glaucoma. The co-primary endpoints were patient-reported health status, intraocular pressure, and incremental cost-effectiveness ratio per quality-adjusted life-year gained 36 months after treatment. Analysis was by intention to treat. This study is registered, number ISRCTN44464607. Findings . Of 419 participants enrolled, 155 had primary angle closure and 263 primary angle-closure glaucoma. 208 were assigned to clear-lens extraction and 211 to standard care, of whom 351 (84%) had complete data on health status and 366 (87%) on intraocular pressure. The mean health status score (0·87 [SD 0·12]), assessed with the European Quality of Life-5 Dimensions questionnaire, was 0·052 higher (95% CI 0·015–0·088, p=0·005) and mean intraocular pressure (16·6 [SD 3·5] mm Hg) 1·18 mm Hg lower (95% CI –1·99 to –0·38, p=0·004) after clear-lens extraction than after standard care. The incremental cost-effectiveness ratio was £14 284 for initial lens extraction versus standard care. Irreversible loss of vision occurred in one participant who underwent clear-lens extraction and three who received standard care. No patients had serious adverse events. Interpretation . Clear-lens extraction showed greater efficacy and was more cost-effective than laser peripheral iridotomy, and should be considered as an option for first-line treatment.
dc.format.extent9
dc.language.isoeng
dc.relation.ispartofLanceten
dc.rightsCopyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en
dc.subjectRE Ophthalmologyen
dc.subjectNDASen
dc.subjectBDCen
dc.subjectR2Cen
dc.subject.lccREen
dc.titleEffectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE) : a randomised controlled trialen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.identifier.doihttps://doi.org/10.1016/S0140-6736(16)30956-4
dc.description.statusPeer revieweden


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