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Meta-analysis of selective laser trabeculoplasty with argon laser trabeculoplasty in the treatment of open-angle glaucoma.
MedLine Citation:
PMID:  23769780     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the efficacy and tolerability of selective laser trabeculoplasty (SLT) and argon laser trabeculoplasty (ALT) in the treatment of open-angle glaucoma.
DESIGN: Systematic review and meta-analysis.
PARTICIPANTS: Six clinic studies, all of which were random controlled trials.
METHODS: Pertinent studies were selected through extensive searches of PubMed, Cochrane Library, Embase, and meeting abstracts. Efficacy measures were weighted by mean differences for intraocular pressure (IOP), as well as change of number of glaucoma medications and relative risks (RRs) for therapeutic IOP responses. Tolerability measures were RRs for adverse events. Pooled estimates were carried out in RevMan software 5.1.
RESULTS: SLT was associated with a numerically larger reduction compared with ALT, with a weighted mean difference (WMD) of 0.60 (95% CI, 0.06-1.14). There was no significant difference in therapeutic IOP responses between SLT and ALT, with a pooled RR of 0.84 (95% CI, 0.51-1.38). Patients who received SLT took fewer glaucoma medications after operations than those who received ALT, with a WMD of 0.29 (95% CI, 0.01-0.56). When compared in patients with previous failed laser treatment (ALT or SLT), SLT was more effective in IOP reduction than ALT with a WMD of 1.48 (95% CI, 0.75-2.21). The frequencies of anterior chamber flare and IOP peak after operation were similar comparing SLT and ALT, with pooled RRs of 0.90 (95% CI, 0.74-1.11) and 0.90 (95% CI, 0.45-1.82), respectively.
CONCLUSIONS: SLT was associated with relatively higher efficacy of IOP lowering compared with ALT. SLT results in a larger reduction of number of glaucoma medications versus ALT, and it appeared to be more effective for patients who did not respond adequately to previous laser treatment. The difference in tolerability of the 2 lasers was not significant.
Authors:
Hao Wang; Jin-Wei Cheng; Rui-Li Wei; Ji-Ping Cai; You Li; Xiao-Ye Ma
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of ophthalmology. Journal canadien d'ophtalmologie     Volume:  48     ISSN:  0008-4182     ISO Abbreviation:  Can. J. Ophthalmol.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045312     Medline TA:  Can J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  186-92     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
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