Efficacy Of Glaucoma Surgical Procedures: A Systematic Review And Metanalysis

Abstract

 

Purpose:

 

Comparison of different surgical modalities for the treatment of open angle glaucoma (OAG).

 

Methods:

 

We searched MEDLINE and EMBASE for articles published up to November 2011. Randomized trials comparing trabeculectomy (TR) with at least one among deep sclerectomy (DS), viscocanalostomy (VC), and canaloplasty (CP) were eligible. The primary endpoint was the mean difference (MeD) between arms in the diurnal intraocular pressure (IOP) reduction from baseline to 6-month assessment or the closer thereafter.

 

Results:

 

Out of 250 retrieved articles, 17 were considered eligible, covering 18 comparisons (8 TR vs. VC; 9 TR vs. DS; 1 TR vs. CP) for a total of 842 eyes from 732 patients. TR seemed to have a better IOP-lowering effect than the other surgeries (MeD -2.24, 95 CI% -3.05-1.43, attached image). Among subgroups no heterogeneity was detected (I²=0).

 

Conclusions:

 

This metanalysis helps to provide a clear picture of the efficacy of current surgical procedures for the treatment of OAG.  

 

Keywords: intraocular pressure • clinical (human) or epidemiologic studies: systems/equipment/techniques • clinical (human) or epidemiologic studies: outcomes/complications