The traditional treatment for angle closure glaucoma has been the laser peripheral iridotomy (LPI) but the recent EAGLE study has shown that by removing the lens inside the eye (a clear lens extraction, CLE) leads to a better quality of life score. Additional benefits were fewer additional intraocular pressure lowering operations were needed, and fewer eye drop medications were needed in the CLE group compared with the LPI group. Nearly two thirds of patients achieved control of their eye pressure after CLE without the need for eye drops compared with one fifth in the LPI group.
The technique of CLE is the same as cataract surgery: the lens of the eye is removed, usually under local anaesthetic, and a new artificial lens is inserted in it’s place. The new lens is much thinner than the human lens and this results in a significant deepening of the front chamber of the eye. This in turn opens up the drainage channels at the front of the eye, leading to a reduction in the eye pressure.
Removing the lens inside the eye (a clear lens extraction, CLE) leads to a better quality of life score.