A meta-analysis of selective laser trabeculoplasty versus antiglaucomatous medication for glaucomatous and ocular hypertensive eyes

Background

Selective laser trabeculoplasty (SLT) and antiglaucomatous medications can be used to treat both glaucoma and ocular hypertension.However, which is more effective and safe remains proofless.

Objective

This meta-analysis was to identify the possible differences in clinical outcomes between SLT and topical medication administration in the treatment of glaucoma and ocular hypertension.

Methods

Pertinent prospective randomized controlled trials that compare the efficacy and safety between SLT and medication were selected by extensive searches of PubMed, Embase, Cochrane Controlled Trials Register database and Wanfang database from their inception to May 2016.The efficacy included the range of intraocular pressure reduce (IOPR) and successful rate in follow-up period were estimated by weighted mean difference (WMD) and the odds ratio (OR) respectively.The safety was to observe the adverse reactions of both SLT and medications.

Results

Six prospective randomized controlled trials were included in the meta-analysis with 598 eyes of 361 patients who suffered from glaucoma and ocular hypertension, including 243 eyes of Caucasian patients, 291 eyes of Asian patients and 67 eyes of other races.Five studies involving 431 eyes compared SLT with medication in terms of IOPR and showed that the IOPR in antiglaucomatous medication group was 0.21 mmHg higher than that in the SLT group [WMD=-0.21 mmHg; 95%(confidence interval) CI: -0.30, -0.11; P<0.000 1]. No statistical heterogeneity was observed among the studies (I²=0%). All the six studies reported success rate and exhibited that the successful rate was higher in antiglaucomatous medication group than that in the SLT group, with statistical significance between the 2 groups (OR=0.57; 95%CI: 0.37, 0.87; P=0.01). No statistical heterogeneity was observed (I²=13%).

Conclusions

Both antiglaucomatous medication and SLT therapies can lower IOP in the patients with glaucoma and ocular hypertension, and the medication therapy seems to be more effective than SLT.

Glaucoma/therapy; Ocular hypertension/therapy; Selective trabeculoplasty; Laser/therapy use; Medications; Randomezid controlled clinical trials; Meta-analysis