A multi-centre randomised controlled trial, funded by the NIHR HTA Programme comparing primary medical treatment with primary augmented trabeculectomy (glaucoma surgery) for patients presenting with newly diagnosed advanced glaucoma.

The trial has a primary patient reported outcome, the vision specific health profile (NEI-VF Q25). The primary outcome was evaluated at 24 months.

TAGS closed recruitment in May 2017 with 453 participants recruited from 27 hospitals across the UK.

TAGS follow-up period was extended to 5 years post-randomisation and the results of this 5 year follow-up have been reported.  The 5 year follow-up showed that, in patients presenting with advanced glaucoma, surgery is safe and has similar wellbeing (quality of life) at 5 years but achieved lower IOP and better-preserved visual field compared with eye-drops.

Funding has now been obtained to follow TAGS participants up for 10 years to see if treatments are equally effective over a longer period.

TAGS is led by Professor Anthony King based at Nottingham University Hospital NHS Trust.

For more information please see the TAGS Study Website



Ongoing - In long term follow up


King AJ, Fernie G, Azuara-Blanco A, et al. Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma—study protocol. British Journal of Ophthalmology 2018;102:922-928. https://bjo.bmj.com/content/102/7/922

King AJ, Hudson J, Fernie G, et al. Baseline Characteristics of Participants in the Treatment of Advanced Glaucoma Study: A Multicenter Randomized Controlled Trial. Am J Ophthalmol. 2020 May;213:186-194. doi: 10.1016/j.ajo.2020.01.026. 

King AJ, Hudson J, Fernie G, et al.  Primary trabeculectomy for advanced glaucoma: pragmatic multicentre randomised controlled trial (TAGS). BMJ 2021;373:n1014 http://dx.doi.org/10.1136/bmj.n1014

King AJ, Fernie G, Hudson J, et al. Primary trabeculectomy versus primary glaucoma eye drops for newly diagnosed advanced glaucoma: TAGS RCT. Health Technol Assess. 2021 Nov;25(72):1-158. doi: 10.3310/hta25720. PMID: 34854808.

King AJ, Hudson J, Azuara-Blanco A, et al. Effects of socioeconomic status on baseline values and outcomes at 24 months in the Treatment of Advanced Glaucoma Study randomised controlled Trial. Br J Ophthalmol. 2024 Jan 29;108(2):203-210. doi: 10.1136/bjo-2022-321922. 

King AJ, Hudson J, Azuara-Blanco A, et al. Evaluating Primary Treatment for People with Advanced Glaucoma: Five-Year Results of the Treatment of Advanced Glaucoma Study.  Ophthalmology. Volume 131, Issue 7, July 2024, Pages 759-770. https://doi.org/10.1016/j.ophtha.2024.01.007