Articles
1390
www.thelancet.com
Vol 388 October 1, 2016
medications and subsequent glaucoma surgery should
be reduced. Furthermore, clear-lens extraction could help
to maintain good visual acuity and improve quality of life
by correcting
hypermetropic refractive error, which
frequently aff ects these patients, and reduce the need for
wearing spectacles.
10
Weighing against initial clear-lens
extraction, though, are the
potential risks of severe
complications associated with intraocular surgery.
We did a multicentre, randomised, controlled trial to
assess the effi
cacy, safety, and cost-eff ectiveness of
clear-lens extraction compared with laser peripheral
iridotomy and topical medical treatment as fi rst-line
therapy in people with newly
diagnosed primary angle
closure with raised intraocular pressure or primary
angle-closure glaucoma (ie, those at the highest risk of
visual loss). We tested the hypothesis that initial clear-
lens extraction would be associated with better quality of
life,
lower intraocular pressure, and less need for
glaucoma surgery at 36 months than standard care.
The protocol of the study has been published.
11
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