Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Abstract

Aims:To evaluate the efficacy and tolerability of nonpenetrating filtering surgery in the treatment of patients with open-angle glaucoma. Methods: Pertinent studies were selected by extensive searches. A total of 17 randomized controlled trials were included in the present meta-analysis. The main outcome measures were risk differences (RDs) of complete success for efficacy and postoperative complications for tolerability. Pooled estimates were computed according to a random-effects model. Results:Viscocanalostomy and deep sclerectomy were significantly less effective than tra- beculectomy, and pooled RDs of complete success were –0.16 (95% confidence interval, CI, –0.30 to –0.02) and –0.10 (–0.19 to 0.00). Deep sclerectomy plus mitomycin C (MMC) was also less effective than trabeculectomy plus MMC, with pooled RD of complete success being –0.16 (95% CI –0.32 to –0.01). Viscocanalostomy and deep sclerectomy caused main complications in fewer patients than trabeculectomy. Conclusions:Viscocanalostomy and deep sclerectomy were less effective than trabeculectomy in the treatment of open-angle glaucoma, and deep sclerectomy plus MMC was also less effective than trabeculectomy plus MMC. However, viscocanalostomy and deep sclerectomy were associated with fewer complications than trabeculectomy.

Visante Anterior Segment Optical Coherence Tomography Analysis of Morphologic Changes After Deep Sclerectomy With Intraoperative Mitomycin-C and No Implant Use

“…4 In this sense, an implant was believed to be necessary to reduce intrascleral wound healing, thus helping to maintain an empty intrascleral lake between the external flap and trabecular meshwork during the time of maximal healing. 4 However, Cheng et al 5 have reported that there was insufficient evidence to support the statement that implants increased success rates after NPDS.…”

Comparative Efficacy and Safety Profile Between Trabeculectomy and Deep Sclerectomy

“…Yapılan ça-lışmalarda, her ne kadar yeni teknikler tanımlansa da, penetran cerrahiler daha yüksek komplikasyon oranları, nonpenetran cerrahiler de daha düşük etkinlikle birlikte anılmaktadır [6,7]. Yapıl-mış birçok prospektif randomize çalışmada, GİB'in uzun dönem etkin bir şekilde düşürülmesinden taviz verilerek, ilk seçenek olarak komplikasyonların daha az yaşandığı nonpenetran cerrahilerin tercih edilmesi tavsiye edilmektedir [8,9]. Çalışmamızı planlarken yerli kaynakçayı taradığımızda trabekü-lektomi ve derin sklerektomi üzerine Sarıcaoğlu ve ark.…”

Comparing Viscocanalostomy with Trabeculectomy

“…The first two papers by Cheng et al 19,20 showed that trabeculectomy had a better efficacy with a risk difference for complete success of -0.16 (95 % confidence interval [CI]: -0.30 to -0.02), a mean IOP reduction at two years of 45.6 % for trabeculectomy and 30.2 % for viscocanalostomy, and a complete success rate at four years of 47.6 and 22.7 %, respectively. The two studies confirmed fewer complications after viscocanalostomy than after trabeculectomy.…”