Hussein Osama, Musleh Ayman, Abukhaled Yara, Hammad Abdullah, Feras Radi, Abu Serhan Hashem
School of Medicine, The University of Jordan, Amman, Jordan.
College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.
Eye (Lond). 2025 Jul 24. doi: 10.1038/s41433-025-03927-7.
We evaluated the effect of phacoemulsification on intraocular pressure (IOP) and the reduction of glaucoma medications in patients with glaucoma. Our protocol was registered in PROSPERO (CRD42024533437). We conducted a systematic search in PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) with at least 10 eyes and a 12-month minimum follow-up. Risk of bias assessment was performed using the Cochrane risk-of-bias tool. A random-effects model meta-analysis was used, and heterogeneity was assessed using Cochran's Q and I² statistics. We included 41 RCTs with a total of 2315 eyes in the phacoemulsification-alone group. In ACG patients, the pooled effect showed a percentage of IOP reduction (IOPR%) of 35.22% with a mean IOP reduction of -9.51 mmHg, p < 0.001 at 12 months, and an IOPR% of 27.47% with a mean reduction of -6.37 mmHg, p < 0.001 at 24 months. For OAG patients, the pooled effect showed an IOPR% of 18.94% with a significant absolute change of -4.35 mmHg, p < 0.001 at 12 months, and IOPR% of 16.95% with an absolute IOP change of -3.83 mmHg, p < 0.001 at 24 months. In ACG patients, medication use decreased by 67.13% at 12 months and 51.58% at 24 months (p < 0.001 for both), while in OAG patients, the reduction was 45.52% at 12 months and 50.19% at 24 months (p < 0.001). In conclusion, standalone phacoemulsification significantly lowers IOP and reduces the need for glaucoma medications in patients with glaucoma.
我们评估了超声乳化术对青光眼患者眼压（IOP）的影响以及青光眼药物使用的减少情况。我们的方案已在PROSPERO（CRD42024533437）注册。我们在PubMed、Scopus、Cochrane对照试验中央注册库（CENTRAL）和Web of Science中进行了系统检索，以查找至少有10只眼且至少随访12个月的随机临床试验（RCT）。使用Cochrane偏倚风险工具进行偏倚风险评估。采用随机效应模型进行荟萃分析，并使用Cochran's Q和I²统计量评估异质性。我们纳入了41项RCT，单独超声乳化术组共有2315只眼。在急性闭角型青光眼（ACG）患者中，汇总效应显示12个月时眼压降低百分比（IOPR%）为35.22%，平均眼压降低-9.51 mmHg，p < 0.001；24个月时IOPR%为27.47%，平均降低-6.37 mmHg，p < 0.001。对于开角型青光眼（OAG）患者，汇总效应显示12个月时IOPR%为18.94%，绝对变化显著为-4.35 mmHg，p < 0.001；24个月时IOPR%为16.95%，眼压绝对变化为-3.83 mmHg，p < 0.001。在ACG患者中，12个月时药物使用减少67.13%，24个月时减少51.58%（两者p均< 0.001），而在OAG患者中，12个月时减少45.52%，24个月时减少50.19%（p < 0.001）。总之，单独的超声乳化术可显著降低青光眼患者的眼压并减少青光眼药物的使用需求。
