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



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EAGLE - a randomised controlled trial

Clear-lens extraction 
(n=208)
Laser peripheral 
iridotomy (n=211)
Missing data
Demographics
Women
122 (59%)
121 (57%)
0
Chinese origin
62 (30%)
66 (31%)
0
Age (years)
67·0 (61·0–73·0)
67·0 (61·0–73·0)
0
Ocular characteristics and treatments
Both eyes suitable for treatment
76 (37%)
76 (36%)
0
Study eye was right eye
110 (53%)
118 (56%)
0
Diagnosis in study eye
PAC
80 (38%)
75 (36%)
0
PACG
127 (61%)
136 (64%)
0
Missing
1 (0%)
Systemic warfarin use
11 (5%)
7 (3%)
1
Systemic α-agonist use
17 (8%)
25 (12%)
0
Glaucoma topical medication
None
83 (40%)
79 (37%)
0
One
71 (34%)
79 (37%)
0
Two
35 (17%)
37 (18%)
0
Three
16 (8%)
10 (5%)
0
Four
2 (1%)
5 (2%)
0
Five
1 (0%)
1 (0%)
0
Glaucoma oral medication
0
2 (1%)
0
IOP (mm Hg)
30·0 (24·0 to 33·0)
30·0 (26·0 to 33·0)
0
Axial length (mm)
22·5 (22·0 to 23·1)
22·7 (22·1 to 23·2)
7
Anterior chamber depth (mm)
2·5 (2·3 to 2·7)
2·5 (2·3 to 2·7)
17
Refractive error (dioptres)
1·6 (0·5 to 3·0)
1·1 (0·0 to 2·4)
39
Visual fi eld mean deviation (dB)
–3·0 (–7·0 to –0·8)
–3·5 (–7·2 to –1·3)
42
Central corneal thickness (μm)
553·0 (528·0 to 576·0)
551·0 (522·0 to 582·0)
5
Gonioscopy (angle closure º)
Closure without indentation
300·0 (270·0 to 360·0)
360·0 (270·0 to 360·0)
23
Synechial closure
90·0 (20·0 to 180·0)
90·0 (10·0 to 180·0)
247
BCVA, ETDRS (N letters)
80·0 (74·0 to 85·0)
79·0 (71·0 to 85·0)
7
Binocular BCVA, ETDRS
85·0 (79·0 to 88·0)
84·0 (79·0 to 88·0)
17
Patient-reported instrument scores
NEI-VFQ-25
90·9 (83·6 to 95·5)
90·3 (83·3 to 95·9)
6
EQ-5D
1·000 (0·796 to 1·000)
1·000 (0·796 to 1·000)
11
Glaucoma Utility Index
0·897 (0·791 to 0·991)
0·921 (0·791 to 1·000)
17
Data are number (%) or median (IQR). PAC=primary angle closure. PACG=primary angle-closure glaucoma. 
IOP=intraocular pressure. MD=mean deviation index. BCVA=best-corrected visual acuity. ETDRS=Early Treatment 
Diabetic Retinopathy Study. NEI-VFQ–25=National Eye Institute Visual Function Questionnaire-25. EQ-5D=European 
Quality of Life-5 Dimensions questionnaire.
Table 1: Baseline characteristics 


Articles
www.thelancet.com Vol 388 October 1, 2016 
1393
Non-parametric bootstrapping was used to generate 
95% CIs
for the estimated diff erences in mean costs and 
QALYs, and to ascertain the probability of the ICER for the 
clear-lens extraction approach being cost-eff ective at 
diff erent ceiling ratios. In accordance with the guidance of 
the National Institute for Health and Care Excellence,
28
we 
report these probabilities at ceiling ratios of £20 000 and 
£30 000 per QALY gained to represent decision makers’ 
maximum willingness to pay per QALY gained. All 
analyses were also repeated with a multiple imputation 
dataset (n=20) generated with the use of chained equations 
to deal with missing cost and utility data.
29
Analyses were 
done with Stata version 12. This study is registered with 
the ISRCTN registry, number ISRCTN44464607.

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