Selective Laser Trabeculoplasty Outcomes in Phakic and Pseudophakic Patients: A Meta-Analysis

To perform a meta-analysis to compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes.

Scopus, Embase, PubMed, and gray literature were searched for studies comparing SLT outcomes in phakic and pseudophakic patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). The mean change in intraocular pressure was compared using a standardized mean difference (SMD) meta-analysis (RevMan 5.4.1). Begg's funnel plots and Egger's test were used to assess publication bias.

Eleven studies with 1058 eyes (323 pseudophakic and 735 phakic) were identified. There was no statistically significant difference in the observed efficacy of SLT between pseudophakic and phakic eyes (SMD = -0.10; 95% confidence interval = -0.24, 0.03; P = 0.14). There was no publication bias or heterogeneity (I ² = 0%; P = 0.66) detected. Subgroup analysis of studies stratified by length of follow-up in months (6, 12, and 24 or greater) revealed no significant difference in SLT efficacy at the different time points (P = 0.86, P = 0.59, and P = 0.16, respectively).

Our pooled and subgroup analysis revealed no significant difference in SLT response between the two populations. Our results support SLT as a viable treatment option for patients with OAG or OHT regardless of pseudophakic status.