Evidence map›Paper›PMID 27707497›Full record

ArticleLancet (London, England)2016

Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial.

Augusto Azuara-Blanco, Jennifer Burr, Craig Ramsay, David Cooper, Paul J Foster, David S Friedman, Graham Scotland, Mehdi Javanbakht, Claire Cochrane, John Norrie and 1 more

Registry-linked trialOpen access · hybridAbstract readComment
PubMed Publisher
In one paragraph

Article in Lancet (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03159780 (Prevalence of Corneal Astigmatism Before Glaucoma Surgery in Chinese Patients With Primary Angle-closure Glaucoma), which is not on this map. Cited by 228 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
228citing papers in PubMed, 10 pooled it
37.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03159780 completednot on this mapstarted 2017, after this paper: background citation

Prevalence of Corneal Astigmatism Before Glaucoma Surgery in Chinese Patients With Primary Angle-closure Glaucoma

TypeobservationalSponsorMingkai LinRan2017 to 2017Enrolled808ConditionsGlaucoma, Angle-Closure, Astigmatism
3 · Its place in the literature

Who cites it

228 citing papers in PubMed, 10 syntheses or guidelines pooled it, 530 citations in OpenAlex.

  1. Pooled it
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  5. Cataract surgery and IOP: a systematic review of randomised controlled trials.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Lens extraction for chronic angle-closure glaucoma.The Cochrane database of systematic reviews · 2021
    Pooled it
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  13. Twelve-month results of ab interno trabeculectomy with Kahook Dual Blade: an interventional, randomized, controlled clinical study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021
    Trial
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  17. Effects of lens extraction versus laser peripheral iridotomy on anterior segment morphology in primary angle closure suspect.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2019
    Trial
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168 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Augusto Azuara-BlancoCentre for Public Health, Queen's University Belfast, Belfast, UK. Electronic address: a.azuara-blanco@qub.ac.uk.
Jennifer BurrSchool of Medicine, University of St Andrews, St Andrews, UK.
Craig RamsayHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
David CooperHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
Paul J FosterNIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, UK.
David S FriedmanJohns Hopkins Wilmer Eye Institute, Baltimore, MD, USA.
Graham ScotlandHealth Services Research Unit, University of Aberdeen, Aberdeen, UK; Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Mehdi JavanbakhtHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Claire CochraneHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
John NorrieHealth Services Research Unit, University of Aberdeen, Aberdeen, UK; Centre for Health Care Randomised Trials, University of Aberdeen, Aberdeen, UK.
EAGLE study group
University of Aberdeen · GBJohns Hopkins University · USMoorfields Eye Hospital · GBQueen's University Belfast · GBUniversity of St Andrews · GB

Funding

Chief Scientist Office HERU1Chief Scientist Office HSRU1Medical Research Council G0701604
6 · The paper itself

Abstract

backgroundPrimary 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.

methodsFrom 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.

findingsOf 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.

interpretationClear-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.

fundingMedical Research Council.

Indexed as

Quality of LifeCataract ExtractionGlaucoma, Angle-ClosureHumansIntraocular PressureLens, Crystalline

Identifiers

PMID27707497
OpenAlexW2525441444

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.