Efficacy and safety of transscleral cyclophotocoagulation versus cyclocryotherapy in the treatment of intractable glaucoma: A systematic review and meta-analysis.

Autor: Wang SY; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan., Yen CY; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan., Kuo BI; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan., Yen JC; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan., Liou SW; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.; Department of Ophthalmology, Shin Kong Memorial Wu Ho-Su Hospital, Taipei, Taiwan., Chen CC; Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2024 Mar; Vol. 102 (2), pp. e156-e167. Date of Electronic Publication: 2023 Sep 15.
DOI: 10.1111/aos.15754
Abstrakt: To perform a meta-analysis to compare the efficacy and safety of diode laser transscleral cyclophotocoagulation (TSCPC) and cyclocryotherapy (CCT) in the treatment of intractable glaucoma. Systemic searches of the Ovid MEDLINE, EMBASE, and Cochrane Library databases yielded experimental and observational comparative studies. TSCPC and CCT efficacy and safety outcomes were compared. Subgroup analyses of participant ethnicity, preoperative intraocular pressure (IOP) level, and underlying causes of glaucoma were conducted. The pooled effects were computed using the random-effects model. The meta-analysis included nine studies totalling 668 eyes. There was no statistically significant difference between the TSCPC and CCT groups in the IOP reduction (IOPR%), decrease in antiglaucoma medications, the operative success rate with or without medications, or retreatment rate in the efficacy analysis. In the subgroup analysis, CCT had a better IOP-lowering effect among non-Asian participants and a non-inferior IOPR% to TSCPC among Asian participants. TSCPC and CCT were associated with similar rates of deterioration in visual acuity, postoperative visual analog scale, and other analysed postoperative complications in the safety analysis. In both groups, severe complications were uncommon. Diode laser TSCPC and CCT had nearly equivalent clinical efficacy in treating intractable glaucoma, while CCT demonstrated a better IOP-lowering effect in non-Asian. Both cyclodestructive procedures have a comparable safety profile.
(© 2023 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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