Safety and efficacy of canaloplasty versus trabeculectomy in treatment of glaucoma

Abstract

We assess the efficacy and safety of canaloplasty and trabeculectomy for treatment of glaucoma. We searched the China National Knowledge Infrastructure, PubMed, Web of Science, and WanFang databases for potentially eligible studies. Pooled risk ratio (RR) with 95% confidence interval (CI) was calculated using random- or fixed-effect models if appropriate. Eight studies were included for meta-analysis. There was no difference in intraocular pressure at 6 months (WMD = 0.97, 95%CI: -0.48-2.41). Intraocular pressure in canaloplasty group 12 months after operation was higher than in trabeculectomy group (WMD = 1.90, 95%CI: 0.12-3.69), P < 0.05). The canaloplasty group showed higher success rate than trabeculectomy group (RR = 0.86, 95%CI: 0.77-0.97). The canaloplasty group was more likely to have hyphema (RR = 2.96, 95%CI: 1.51-5.83), P < 0.05) than trabeculectomy group (RR = 0.24, 95, CI(0.06-0.89), P < 0.05]. The incidence of and hypotony and postoperative choroid abnormalities in canaloplasty group was significantly lower than that in trabeculectomy group (RR = 0.30, 95%CI: 0.11-0.83; RR = 0.24, 95%CI: 0.09-0.66), P < 0.05). Both trabeculectomy and canaloplasty can significantly reduce the intraocular pressure in glaucoma patients at 12 months after operation, trabeculectomy leads a more marked IOP decrease than canaloplasty at the cost of a higher complication rate and more demanding for postoperative care.

Long-Term Efficacy and Safety of Modified Canaloplasty Versus Trabeculectomy in Open-Angle Glaucoma

“…Surgical success after the follow-up period was more than twice as high after trabeculectomy than after modified canaloplasty, independently from how success was defined. Previous studies showed inconsistent findings regarding surgical success: Some studies found similar results to this study with a higher complete success after trabeculectomy [ 12 , 16 , 17 , 18 , 19 ], while in other studies both methods reached comparable results [ 20 , 21 ]. A long-termed follow-up period of up to three years in a mixed cohort was reported by Nassri et al [ 12 ] and there was a similar gap of complete success between canaloplasty and trabeculectomy as in the present study.…”

The Efficacy and Safety of Canaloplasty Vs Trabeculectomy Either Standalone or Combined with Cataract Surgery: An Updated Meta-Analysis

“…To date, this is the most comprehensive and thorough systematic review and meta-analysis of the comparative e cacy and safety between TE and CP either as standalone or combined with phacoemulsi cation. There are three published systematic reviews and meta-analyses in this regard 11,15,31 . In 2016, Liu et al 15 , analyzed six studies comparing CP to TE, revealing a greater reduction in IOP and a higher complication rate in favor of TE.…”

“…There are three published systematic reviews and meta-analyses in this regard 11,15,31 . In 2016, Liu et al 15 , analyzed six studies comparing CP to TE, revealing a greater reduction in IOP and a higher complication rate in favor of TE. Meanwhile, the study of Lin et al 31 , which was published in 2017, yielded con icting results, showing more IOP reduction in the CP group, with no signi cant difference between both groups regarding complete and quali ed success.…”

“…Other outcomes were assessed in only two to three studies, with a minimal sample size that limited the accuracy and validity of driven ndings. Since then, numerous studies have been conducted with con icting results [12][13][14][15] . Therefore, we aimed to conduct this updated systematic review and meta-analysis to measure the e cacy and safety of trabeculectomy versus canaloplasty either as standalone or combined with phacoemulsi cation in terms of IOP, complete success, quali ed success, failure, revision surgery, and complications.…”

Evaluation of the Efficacy and Safety of Canaloplasty and iStent Bypass Implantation in Patients with Open-Angle Glaucoma: A Review of the Literature

“…Trabeculectomy is the gold standard of antiglaucoma surgery, but it is associated with a high number of postoperative complications and requires more frequent postoperative intervention. With canaloplasty, the physiological drainage of the aqueous humor through the bead canal is increased by opening or widening of the Schlemm’s canal, without the need to create a functional filtering bleb [ 27 ]. Therefore, the risk of potential pathway for pathogens to enter the eyeball and cause inflammation inside the eyeball is eliminated as well.…”