Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort

Day AC 1 , Cooper D 2 , Burr J 3 , Foster PJ 1 , Friedman DS 4 , Gazzard G 1 Show all authors , Che-Hamzah J 5 , Aung T 6 , Ramsay CR 2 , Azuara-Blanco A 7

Affiliations 

  • 1 NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
  • 2 Health Services Research Unit, University of Aberdeen, Aberdeen, UK
  • 3 School of Medicine, University of St Andrews, St Andrews, UK
  • 4 John Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
  • 5 Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 6 Singapore Eye Research Institute, Singapore
  • 7 Centre for Public Health, Queen's University Belfast, Belfast, UK
Br J Ophthalmol, 2018 12;102(12):1658-1662.
PMID: 29453222 DOI: 10.1136/bjophthalmol-2017-311447

Abstract

BACKGROUND: To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial.

METHODS: Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants were ≥50 years old and newly diagnosed with (1) primary angle closure (PAC) with intraocular pressure above 30 mm Hg or (2) PAC glaucoma. We report the postoperative corrected distance visual acuity (CDVA) and refractive outcomes at 12 and 36 months postoperatively for those who underwent CLE.

RESULTS: Of the 419 participants, 208 were randomised to CLE. Mean baseline CDVA was 77.9 (SD 12.4) letters and did not change significantly at 36 months when mean CDVA was 79.9 (SD 10.9) letters. Mean preoperative spherical equivalents were +1.7 (SD 2.3) and +0.08 (SD 0.95) diopters (D) at 36 months. Fifty-nine per cent and 85% eyes were within ±0.5D and ±1.0D of predicted refraction, respectively, at 36 months.

CONCLUSIONS: Mean CDVA in patients undergoing CLE for angle-closure glaucoma appeared stable over the 3-year study period. Refractive error was significantly reduced with surgery but refractive predictability was suboptimal.

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* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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