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

Alexander C. Day; David Cooper; Jennifer Burr; Paul J. Foster; David S. Friedman; Gus Gazzard; Jemaima Che-Hamzah; Tin Aung; Craig R. Ramsay; Augusto Azuara-Blanco

doi:10.1136/bjophthalmol-2017-311447

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

Alexander C. Day, David Cooper, Jennifer Burr, Paul J. Foster, David S. Friedman, Gus Gazzard, Jemaima Che-Hamzah, Tin Aung, Craig R. Ramsay, Augusto Azuara-Blanco^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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. Fiftynine 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.

Original language	English
Pages (from-to)	1658-1662
Number of pages	5
Journal	British Journal of Ophthalmology
Volume	102
Issue number	12
Early online date	16 Feb 2018
DOIs	https://doi.org/10.1136/bjophthalmol-2017-311447
Publication status	Published - Dec 2018

Keywords

National Ophthalmology Database
Electronic multicenter audit
Cataract surgery
Visual acuity
Benchmark standards
Royal College
Accuracy

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Day, A. C., Cooper, D., Burr, J., Foster, P. J., Friedman, D. S., Gazzard, G., Che-Hamzah, J., Aung, T., Ramsay, C. R., & Azuara-Blanco, A. (2018). Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort. British Journal of Ophthalmology, 102(12), 1658-1662. https://doi.org/10.1136/bjophthalmol-2017-311447

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

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. Fiftynine 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.",

keywords = "National Ophthalmology Database, Electronic multicenter audit, Cataract surgery, Visual acuity, Benchmark standards, Royal College, Accuracy",

author = "Day, {Alexander C.} and David Cooper and Jennifer Burr and Foster, {Paul J.} and Friedman, {David S.} and Gus Gazzard and Jemaima Che-Hamzah and Tin Aung and Ramsay, {Craig R.} and Augusto Azuara-Blanco",

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doi = "10.1136/bjophthalmol-2017-311447",

language = "English",

volume = "102",

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Day, AC, Cooper, D, Burr, J, Foster, PJ, Friedman, DS, Gazzard, G, Che-Hamzah, J, Aung, T, Ramsay, CR & Azuara-Blanco, A 2018, 'Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort', British Journal of Ophthalmology, vol. 102, no. 12, pp. 1658-1662. https://doi.org/10.1136/bjophthalmol-2017-311447

TY - JOUR

T1 - Clear lens extraction for the management of primary angle closure glaucoma

T2 - surgical technique and refractive outcomes in the EAGLE cohort

AU - Day, Alexander C.

AU - Cooper, David

AU - Burr, Jennifer

AU - Foster, Paul J.

AU - Friedman, David S.

AU - Gazzard, Gus

AU - Che-Hamzah, Jemaima

AU - Aung, Tin

AU - Ramsay, Craig R.

AU - Azuara-Blanco, Augusto

PY - 2018/12

Y1 - 2018/12

N2 - 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. Fiftynine 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.

AB - 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. Fiftynine 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.

KW - National Ophthalmology Database

KW - Electronic multicenter audit

KW - Cataract surgery

KW - Visual acuity

KW - Benchmark standards

KW - Royal College

KW - Accuracy

U2 - 10.1136/bjophthalmol-2017-311447

DO - 10.1136/bjophthalmol-2017-311447

M3 - Article

SN - 0007-1161

VL - 102

SP - 1658

EP - 1662

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

IS - 12

ER -

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

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