Selective Laser Trabeculoplasty Versus Medical Therapy for the Treatment of Open Angle Glaucoma or Ocular Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 2 4区 医学 Q2 OPHTHALMOLOGY
Journal of Glaucoma Pub Date : 2024-12-01 Epub Date: 2024-07-17 DOI:10.1097/IJG.0000000000002466
Matheus Pedrotti Chavez, Guilherme Barroso Guedes, Eric Pasqualotto, Lucca Moreira Lopes, Rafael Oliva Morgado Ferreira, Eduardo Soares Maia Vieira de Souza, Tiago Tomaz de Souza
{"title":"Selective Laser Trabeculoplasty Versus Medical Therapy for the Treatment of Open Angle Glaucoma or Ocular Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Matheus Pedrotti Chavez, Guilherme Barroso Guedes, Eric Pasqualotto, Lucca Moreira Lopes, Rafael Oliva Morgado Ferreira, Eduardo Soares Maia Vieira de Souza, Tiago Tomaz de Souza","doi":"10.1097/IJG.0000000000002466","DOIUrl":null,"url":null,"abstract":"<p><strong>Prcis: </strong>Selective laser trabeculoplasty (SLT) and medical therapy groups displayed comparable intraocular pressure (IOP) at most follow-ups. SLT was associated with significantly decreased rates of glaucoma surgeries, antiglaucomatous medications, and ocular adverse effects.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of SLT compared with medical therapy in the treatment of open angle glaucoma (OAG) or ocular hypertension (OHT).</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Embase, Cochrane Library and Web of Science databases. Randomized controlled trials (RCTs) comparing SLT with medical therapy were included. We computed mean differences (MDs) or standardized mean differences (STDs) for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Software R, version 4.2.1, was used for statistical analyses. Subgroup analyses were performed on treatment-naive patients and on the class of drugs in the medical therapy group.</p><p><strong>Results: </strong>Fourteen RCTs comprising 1706 patients were included, of whom 936 were submitted to SLT. Medical therapy was associated with a significantly improved IOP at 1 month and a higher proportion of patients achieving ≥20% IOP reduction. There were no significant differences between groups in IOP at 2, 3, 6, and 12 months, IOP fluctuation, rate of eyes at target IOP, visual field, and quality of life. The SLT group exhibited significantly decreased rates of glaucoma surgeries, antiglaucoma medications, and ocular adverse effects.</p><p><strong>Conclusions: </strong>SLT demonstrated comparable efficacy to medical therapy in IOP control at most follow-ups, along with favorable impacts on critical treatment-related factors. Our findings support SLT as a safe and effective treatment for OAG or OHT.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"973-986"},"PeriodicalIF":2.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002466","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Prcis: Selective laser trabeculoplasty (SLT) and medical therapy groups displayed comparable intraocular pressure (IOP) at most follow-ups. SLT was associated with significantly decreased rates of glaucoma surgeries, antiglaucomatous medications, and ocular adverse effects.

Purpose: To evaluate the efficacy and safety of SLT compared with medical therapy in the treatment of open angle glaucoma (OAG) or ocular hypertension (OHT).

Methods: A systematic search was performed in PubMed, Embase, Cochrane Library and Web of Science databases. Randomized controlled trials (RCTs) comparing SLT with medical therapy were included. We computed mean differences (MDs) or standardized mean differences (STDs) for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Software R, version 4.2.1, was used for statistical analyses. Subgroup analyses were performed on treatment-naive patients and on the class of drugs in the medical therapy group.

Results: Fourteen RCTs comprising 1706 patients were included, of whom 936 were submitted to SLT. Medical therapy was associated with a significantly improved IOP at 1 month and a higher proportion of patients achieving ≥20% IOP reduction. There were no significant differences between groups in IOP at 2, 3, 6, and 12 months, IOP fluctuation, rate of eyes at target IOP, visual field, and quality of life. The SLT group exhibited significantly decreased rates of glaucoma surgeries, antiglaucoma medications, and ocular adverse effects.

Conclusions: SLT demonstrated comparable efficacy to medical therapy in IOP control at most follow-ups, along with favorable impacts on critical treatment-related factors. Our findings support SLT as a safe and effective treatment for OAG or OHT.

治疗开角型青光眼或眼压过高的选择性激光小梁成形术与药物疗法:随机对照试验的系统回顾和 Meta 分析。
Prcis:选择性激光小梁成形术(SLT)组与药物治疗组在大多数随访中显示出相当的眼压(IOP)。目的:评估选择性激光小梁成形术(SLT)与药物疗法相比,在治疗开角型青光眼(OAG)或眼压过高(OHT)方面的有效性和安全性:在 PubMed、Embase、Cochrane Library 和 Web of Science 数据库中进行了系统检索。纳入了比较 SLT 与药物治疗的随机对照试验(RCT)。我们计算了连续终点的平均差(MDs)或标准化平均差(STDs),以及二元终点的风险比(RRs)和95%置信区间(CIs)。异质性用I2统计量进行评估。统计分析使用 4.2.1 版 R 软件。对未接受治疗的患者和药物治疗组的药物类别进行了分组分析:结果:共纳入了 14 项研究,1 706 名患者,其中 936 人接受了 SLT 治疗。接受药物治疗的患者在 1 个月后眼压明显提高,眼压降低≥20% 的患者比例更高。两组患者在 2、3、6 和 12 个月时的眼压、眼压波动、达到目标眼压的眼睛比例、视野和生活质量方面没有明显差异。SLT组的青光眼手术率、抗青光眼药物治疗率和眼部不良反应明显降低:结论:在大多数随访中,SLT 在控制眼压方面的疗效与药物治疗相当,同时对治疗相关的关键因素产生了有利影响。我们的研究结果表明,SLT 是一种安全有效的 OAG 或 OHT 治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信