Non-penetrating filtration surgery versus trabeculectomy in postoperative astigmatism: a Meta-analysis

Abstract

Objective Trabeculectomy and non-penetrating trabecular surgery are common operations for glaucoma. This meta-analysis aims to compare the effect of trabeculectomy and non-penetrating trabecular surgery in postoperative astigmatism of patients with glaucoma. Methods We searched the PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure to identify studies that, compared between trabeculectomy and non-penetrating trabecular surgery in patients with glaucoma. The time frame for the search was from the time of construction to April 2024. There were no restrictions regarding study type or type of glaucoma. The primary endpoint was the surgically induced astigmatism assessed 6 months after operation. Results Five eligible studies were included in this meta-analysis and presented data for 359 eyes with various types of glaucoma at different stages. The results revealed an increase in astigmatism in patients with glaucoma after trabeculectomy and non-penetrating trabecular surgery. Trabeculectomy had a higher incidence of astigmatism than in the non-penetrating trabecular surgery group at or around 6 months postoperatively, and the difference was statistically significant. (SMD = 0.51, 95% CI = 0.19 to 0.83, P = 0.002). Conclusion Our results demonstrated that both trabeculectomy and non-penetrating trabecular surgery could increase astigmatism until 6 months after operation. Moreover, non-penetrating trabecular surgery group seems to have less influence on astigmatism. Studies with longer follow-up durations and larger sample sizes are necessary in the future. Trial registration number CRD42024517708