Safarpour Lima Behzad, Sayanjali Shima
Clarity Eye Institute, Vaughan, ON.
Eur J Transl Myol. 2024 Oct 22;34(4):12931. doi: 10.4081/ejtm.2024.12931.
This study aims to evaluate the efficacy of selective laser trabeculoplasty in improving the intraocular pressure in patients diagnosed with open-angle glaucoma. A comprehensive search was performed across electronic databases, including PubMed, Scopus, and Web of Science, until June 2024, using keywords related to "selective laser trabeculoplasty" and "open-angle glaucoma." Studies were chosen based on set eligibility criteria. Data extraction was carried out by two independent reviewers, and statistical analyses were performed using a random-effects model to calculate the pooled mean differences in IOP reduction and overall success rates. The initial search yielded 3111 articles, with 23 studies included in the systematic review and 22 in the meta-analysis. The pooled MD in IOP reduction between the SLT and control groups was -1.44 mm Hg (95% CI: -2.19 to -0.70, p < 0.01). Subgroup analyses revealed a MD of -0.76 mm Hg (95% CI: -1.31 to -0.21, p < 0.01) when comparing SLT to medication, and -0.42 mm Hg (95% CI: -0.64 to -0.19, p < 0.01) when comparing 180-degree SLT to 360-degree SLT. The pooled success rate favored SLT with an odds ratio (OR) of 0.71 (95% CI: 0.51 to 0.99, p = 0.05). There was significant heterogeneity among the studies (I² = 71%). SLT is effective in lowering IOP in OAG patients, demonstrating significant efficacy compared to medication and different SLT protocols. The findings underscore SLT's potential as a reliable treatment option. However, the observed heterogeneity underscores the necessity for standardized protocols in future research to improve comparability and verify SLT's long-term effectiveness.
本研究旨在评估选择性激光小梁成形术在改善开角型青光眼患者眼压方面的疗效。截至2024年6月,在包括PubMed、Scopus和Web of Science在内的电子数据库中进行了全面检索,使用了与“选择性激光小梁成形术”和“开角型青光眼”相关的关键词。根据设定的纳入标准选择研究。由两名独立的评审员进行数据提取,并使用随机效应模型进行统计分析,以计算眼压降低的合并平均差异和总体成功率。初步检索得到3111篇文章,其中23项研究纳入系统评价,22项纳入荟萃分析。选择性激光小梁成形术(SLT)组与对照组眼压降低的合并平均差为-1.44 mmHg(95%CI:-2.19至-0.70,p<0.01)。亚组分析显示,SLT与药物治疗相比,平均差为-0.76 mmHg(95%CI:-1.31至-0.21,p<0.01);180度SLT与360度SLT相比,平均差为-0.42 mmHg(95%CI:-0.64至-0.19,p<0.01)。合并成功率支持SLT,优势比(OR)为0.71(95%CI:0.51至0.99,p=0.05)。研究之间存在显著异质性(I²=71%)。SLT在降低开角型青光眼患者眼压方面有效,与药物治疗和不同的SLT方案相比显示出显著疗效。研究结果强调了SLT作为一种可靠治疗选择的潜力。然而,观察到的异质性强调了未来研究中采用标准化方案以提高可比性并验证SLT长期有效性的必要性。