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Combined Surgery Versus Phacoemulsification Alone for Patients with Primary Angle‑Closure Glaucoma: A meta-analysis
Lin Yao1, Xian Yang2, Shaoyou Jia2
1Qingdao Aier Eye Hospital, Qingdao, China.
Seminars in Ophthalmology
|November 17, 2022
Summary
Combined surgery significantly lowers intraocular pressure (IOP) in primary angle-closure glaucoma (PACG) patients but increases complications. Phacoemulsification alone may improve visual acuity in medically controlled PACG.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Efficacy
Background:
- Primary angle-closure glaucoma (PACG) poses a significant risk to vision.
- Comparing surgical interventions is crucial for optimizing PACG management.
- Phacoemulsification and combined surgery (phacoemulsification with trabeculectomy) are key treatment options.
Approach:
- Systematic meta-analysis of seven randomized controlled trials (RCTs).
- Data sourced from PubMed, EMBASE, and Cochrane Library.
- Quality assessment using the Cochrane Handbook and analysis via Revman 5.4 software.
Key Points:
- Combined surgery demonstrated a significant reduction in intraocular pressure (IOP) compared to phacoemulsification alone (MD = -1.45, p = .002).
- Fewer glaucoma medications were required post-combined surgery (MD = -0.59, p = .006).
- No significant difference in best-corrected visual acuity (BCVA) between groups (p = .08), but phacoemulsification alone improved BCVA in medically controlled PACG (p = .02).
- Combined surgery was associated with more complications (RR = 0.22, p = .001).
Conclusions:
- Combined surgery is superior for lowering IOP in PACG patients.
- Phacoemulsification alone may be preferable for BCVA improvement in medically controlled PACG.
- The choice of surgery requires balancing IOP control, visual acuity outcomes, and complication risks.
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