Dr Sunaric-Megevand shared the results of the EAGLE trial with delegates during the ESCRS Main Symposium: Glaucoma for the Cataract Surgeon at the 36th annual ESCRS Congress in Vienna.
“THE results of the EAGLE trial demonstrate that clear lens extraction (CLE) has better efficacy and cost-effectiveness when compared to laser peripheral iridotomy (PI) in primary angle closure and primary angle closure glaucoma (PACG),” said Gordana Sunaric-Megevand, Florissant Ophthalmology Centre, Geneva Switzerland.
EAGLE (Effectiveness of Early Lens Extraction for the Treatment of Primary Angle-Closure Glaucoma) was a randomised controlled trial that compared lens extraction with laser PI.
“Although the current standard of treatment has
long been laser PI, most patients with PACG still need further medical or surgical treatment afterwards, with potentially serious complications,” she said.
“The trial, which randomised 419 patients with an average age of 67 years, concluded that clear-lens extraction showed greater efficacy and was more cost-effective than laser PI, and should be considered as an option for first-line treatment,” said Dr Sunaric-Megevand.
However, more randomised studies will be needed to investigate the effects in other subtypes of angle closure. For example, cases of severe PACG with visual field mean deficit of <-15dB, were excluded from the study. She recommended considering CLE for angle closure after weighing the risks and benefits for each individual patient, bearing in mind that lens extraction can be quite difficult in those eyes with very shallow anterior chambers.