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Surgical treatment for primary angle closure-glaucoma: a Meta analysis
Bo-Lin Deng1, Cheng Jiang, Bin Ma
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China.
International Journal of Ophthalmology
|May 4, 2012
Summary
Phacotrabeculectomy plus intraocular lens implantation (phacotrab+IOL) is more effective than trabeculectomy alone for lowering intraocular pressure in primary angle-closure glaucoma. Phacotrab+IOL also reduces the need for IOP-lowering medications compared to phacoemulsification with IOL.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Interventions
Background:
- Primary angle-closure glaucoma (PACG) is a significant cause of vision loss.
- Effective surgical management is crucial for controlling intraocular pressure (IOP) in PACG.
Purpose of the Study:
- To compare the efficacy and safety of three surgical procedures for PACG: trabeculectomy, phacotrabeculectomy plus intraocular lens implantation (phacotrab+IOL), and phacoemulsification with IOL (phaco+IOL).
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) published up to October 2010.
- Data were collected from major databases including Cochrane Library, PubMed, and EMbase.
- Trial quality was assessed, and RevMan 5.0 software was used for meta-analysis.
Main Results:
- Phacotrab+IOL demonstrated superior IOP reduction compared to trabeculectomy, which was also superior to phaco+IOL.
- Both phacotrab+IOL and phaco+IOL resulted in deeper anterior chambers than trabeculectomy.
- No significant differences were found in visual acuity between phacotrab+IOL and phaco+IOL groups, but phacotrab+IOL required less IOP-lowering medication.
Conclusions:
- Phacotrab+IOL offers superior IOP control in PACG compared to trabeculectomy and phaco+IOL.
- Phacotrab+IOL and phaco+IOL enhance anterior chamber depth more than trabeculectomy.
- Phacotrab+IOL may reduce the long-term need for IOP-lowering drugs in PACG patients.
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