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L. De Fendi, G. A. Viani, V. P. Costa, J. S. Paula; Beta Irradiation as an Adjunct to Trabeculectomy in Open-Angle Glaucoma: A Meta-Analysis of Randomized Controlled Clinical Trials. Invest. Ophthalmol. Vis. Sci. 2009;50(13):419.
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A meta-analysis was conducted to study the efficacy and safety of trabeculectomy (TREC) followed by beta irradiation (BRT/ TREC) compared to TREC alone in patients with glaucoma
A meta-analysis of randomized controlled trials (RCTs) was performed comparing adjunct BRT/TREC to standard TREC after 12 months. The MEDLINE, EMBASE, LILACS, Cochrane Library databases and recent studies of relevant journals were searched.
Of a total of 1350 citations, eight studies (five cohorts, three randomized) were identified and only three RCTs were included in this meta-analysis. Uncontrolled postoperative IOP (> 21 mmHg) was less frequent when BRT was employed compared to the control arm (9/239 = 3.8% versus 38/218 = 17.4%; OR=6.7; 95%CI 3.2-14.3, P < 0.0001). Greater IOP reductions were verified in the BRT arm compared to the control arm (mean difference = 1.68 mmHg, 95%CI = 0.61-2.68, P = 0.002). Although lower IOP levels were observed in all patients treated with adjuvant BRT, only in black individuals there was a significant difference (P = 0.005) compared to TREC alone. There were no significant differences between the BRT/TREC and control arms regarding loss of visual acuity, postoperative complications and necessity of cataract surgery.
This meta-analysis reveals that adjunct BRT increases the success rate of TREC and is not associated with a higher incidence of postoperative complications.
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