Clear lens extraction for primary angle closure: how clear are we?

Azuara-Blanco et al. (1) in their multicentric “EAGLE” study have done a remarkable work in comparing efficacy of clear lens extraction (CLE) vs. laser peripheral iridotomy (LPI) in 155 eyes having newly diagnosed primary angle closure (PAC) with ocular hypertension (IOP ≥30 mmHg) and 263 eyes with early to moderate primary angle closure glaucoma (PACG). The authors reported better quality of life scores and a mean intraocular pressure lower by 1 mmHg in eyes which underwent CLE as compared to LPI at 36 months follow-up. The conclusion of the study was that CLE has a greater efficacy and is more cost effective as compared to the current standard of care (LPI followed by topical therapy) and should therefore be considered as the first line therapy in management of PAC disease (PAC and PACG).