School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
Expert Rev Clin Pharmacol. 2021 Dec;14(12):1527-1534. doi: 10.1080/17512433.2021.1981860. Epub 2021 Sep 24.
Selective laser trabeculoplasty (SLT) can evidently reduce intraocular pressure (IOP) in cases of open-angle glaucoma. Several studies have investigated the effectiveness of anti-inflammatory treatment to relieve discomfort after SLT, but whether such treatments affect the response of SLT remains uncertain.
We systematically searched PubMed, Embase, Web of Science, and Cochrane Library for relevant studies published before 31 March 2021. The major outcomes were the efficacy of post-SLT anti-inflammatory treatment on IOP reduction, incidence of discomfort, and anterior chamber inflammation compared with those of placebo agents.
Five randomized controlled trials with 235 eyes receiving anti-inflammatory treatment and 170 eyes receiving placebo agents were included in the meta-analysis. Compared with placebo, no significant differences were present in IOP reduction effects upon using topical non-steroidal anti-inflammatory drugs or steroid post-SLT. The results were consistent from 1 to 6 months during follow-up. Furthermore, anti-inflammatory treatment had no significant effects on pain or discomfort or the presence of anterior chamber cells 1 h to 1 week post-SLT.
Topical anti-inflammatory treatment after SLT for patients with glaucoma neither significantly affected IOP reduction nor remarkably relieved clinical discomfort and anterior chamber inflammation. Hence, regular use of post-SLT anti-inflammatory treatment may be unnecessary.
选择性激光小梁成形术 (SLT) 可明显降低开角型青光眼的眼压 (IOP)。多项研究调查了抗炎治疗缓解 SLT 后不适的有效性,但此类治疗是否影响 SLT 的反应尚不确定。
我们系统地检索了 PubMed、Embase、Web of Science 和 Cochrane Library,以获取截至 2021 年 3 月 31 日之前发表的相关研究。主要结局是 SLT 后抗炎治疗在降低 IOP、不适发生率和前房炎症方面的疗效,与安慰剂相比。
纳入的 5 项随机对照试验共纳入 235 只眼接受抗炎治疗和 170 只眼接受安慰剂治疗。与安慰剂相比,SLT 后局部使用非甾体类抗炎药或皮质类固醇对 IOP 降低的效果无显著差异。在随访的 1 至 6 个月期间,结果一致。此外,抗炎治疗对疼痛或不适以及 SLT 后 1 小时至 1 周前房细胞的存在无显著影响。
青光眼患者 SLT 后局部使用抗炎治疗既不能显著影响 IOP 降低,也不能显著缓解临床不适和前房炎症。因此,SLT 后常规使用抗炎治疗可能没有必要。