Comparison of pars plana with anterior chamber glaucoma drainage device implantation for glaucoma: a meta-analysis

The purpose of this study was to compare the efficacy and safety of pars plana glaucoma drainage device (PP GDD) with anterior chamber glaucoma drainage device (AC GDD) for the treatment of glaucoma.

We comprehensively searched three databases, including PubMed, EMBASE, and the Cochrane Library databases, selecting the relevant studies. The continuous variables, namely, intraocular pressure (IOP) and glaucoma medications, were pooled by the weighted mean differences (WMDs), and the dichotomous outcomes, including corneal failure incidence and overall complications incidence, were pooled by the odds ratio (ORs).

Four retrospective studies involving 275 eyes were evaluated, with 135 in the PP GDD group and 140 in the AC GDD group. The WMDs of the IOP reduction between the PP GDD group and the AC GDD group were - 1.01 mmHg (95% CI -4.05 to 2.03, p = 0.52). The WMDs of the glaucoma medications reduction between the PP GDD group and the AC GDD group were 0.23 (95% CI -0.11 to 0.56, p = 0.19). The pooled ORs comparing PP GDD group with AC GDD group were 1.01 (95% CI 0.03 to 40.76, p = 0.99) for corneal failure incidence and 1.19 (95% CI 0.68 to 2.09, p = 0.54) for overall complication incidence. There were no significant differences between PP GDD group and AC GDD group on these aspects.

Both PP GDD and AC GDD procedures had similar efficacy of reduction in the IOP and number of medications. They are also both comparable on the safety with similar incidence of corneal failure and overall complications.