Combined Endoscopic Cyclophotocoagulation and Phacoemulsification Versus Phacoemulsification Alone in the Glaucoma Treatment: A Systematic Review and Meta-Analysis.

Autor:	Amaral DC; Faculty of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BRA., Louzada RN; Faculty of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BRA.; Faculty of Medicine, Universidade de São Paulo, São Paulo, BRA., Moreira PHS; Faculty of Medicine, Faculdade Zarns, Salvador, BRA., de Oliveira LN; Faculty of Medicine, Universidade Estadual de Feira de Santana, Feira de Santana, BRA., Yuati TT; Faculty of Medicine, Faculdade de Medicina de Jundiaí, Jundiaí, BRA., Guedes J; Ophthalmology, Glaucoma Research Center, Wills Eye Hospital, Philadelphia, USA., Alves MR; Faculty of Medicine, Universidade de São Paulo, São Paulo, BRA., Mora-Paez DJ; Ophthalmology, Glaucoma Research Center, Wills Eye Hospital, Philadelphia, USA., Monteiro MLR; Faculty of Medicine, Universidade de São Paulo, São Paulo, BRA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Mar 09; Vol. 16 (3), pp. e55853. Date of Electronic Publication: 2024 Mar 09 (Print Publication: 2024).
DOI:	10.7759/cureus.55853
Abstrakt:	The complete safety and efficacy of endoscopic cyclophotocoagulation (ECP) remain unclear in the literature and, to our knowledge, there are no current meta-analyses on phaco-ECP versus phacoemulsification alone to date. Thus, we conducted a systematic review and meta-analysis comparing these two strategies through studies, assessing the effectiveness and safety of outcomes in a population with glaucoma. The protocol for this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023482376). We systematically searched PubMed, Embase, and Web of Science from inception to December 2023. A random-effects model was used for all analyses due to heterogeneity. Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) was used for statistical analysis. Finally, nine studies were included in this comprehensive review and a total of 5389 eyes were analyzed in our study. In comparison to the ECP and phacoemulsification group, those receiving phacoemulsification alone showed better results in best-corrected visual acuity (MD 0.09; CI 95% 0.03 to 0.16; I²=0%), but worse outcomes in intraocular pressure (IOP) (MD -1.49; 95% CI -2.29 to -0.68; I²=29%) and use medications (MD -0.75; 95% CI -0.94 to -0.56; I²=0%) in the last visit. Complication rates, both general and serious, were significantly different between the groups, indicating the potential impact of combined procedures on patient outcomes. Thus, combining ECP with phacoemulsification for glaucoma treatment showed sustained IOP reduction and decreased medication dependence. However, higher complication rates suggest careful consideration of risks. More extensive research with larger trials and longer follow-ups is needed to validate findings and address limitations, providing valuable insights into this treatment approach. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Amaral et al.)
Databáze:	MEDLINE
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