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A Systematic review and meta-analysis on the long-term efficacy and safety of micro pulse diode laser transscleral cyclophotocoagulation in patients with glaucoma / Rudolf Christian F. Palma; Julia Mercedes C. Villalva; Manolito R. Reyes.

Contributor(s): Language: english Publication details: Fairview, Quezon City: Department of Ophthalmology, FEU-NRMF, 2021.Description: 40 pages: illustrations, tables; (in folder) + with flash drive (soft copy)Content type:
  • text
Media type:
  • unmediated
Carrier type:
  • volume
Subject(s): LOC classification:
  • OPH 2021 0002
Summary: Abstract: This systematic review and meta-analysis aim to review available information that addresses the question regarding the long-term efficacy in intraocular pressure (IOP) control and reduction, and the complication rates of Micropulse Transscleral Cyclophotocoagulation in patients with glaucoma. CENTRAL, PubMed and Google Scholar were used as data sources. Studies that include glaucoma patients who underwent MP-TSCPC with one year or more post-operative follow-up with data on pre-and post-operative IOP and complications were considered. NHLBI Quality Assessment Tool was used for the included studies. The treatment effect measures were (1) weighted mean difference (WMD) for the IOP reduction and, (2) proportions for the complication rate. Outcome measures were reported with a 95% confidence interval (CI) and P < 0.05 was considered statistically significant. Analysis was performed using Microsoft Excel and Open Meta Analysis software. In this systematic review, thirteen studies were included in total. Ten were case series, two were observational cohorts, and one randomized controlled trial. Risk of bias studies showed low to moderate risk among the included studies. In random effects model the pooled weighted mean difference was -13.649 (95% CI: {-16.350 - -10. 948], P < 0.001) showing statistically significant reduction in IOP after MP-TSCPC. Pooled proportion risk for complications was 0.418 (95% CI: [0.174 - 0.663], P < 0.001). And among the most common of these complications are the post- operative inflammation at 0.257 (95% CI: [0.094 - 0.420], P = 0.002) and post-operative pain at 0.039 (95% CI: [0.017 - 0.061], P <0.001). There is lack of high-quality evidence on the subject as only one RCT was retrieved. Our findings are based, therefore, mostly on case series and non-controlled observational studies. Our results showed that MP-TSCPC has good efficacy in reducing and controlling IOP after a year post-operatively. It is also safe with low risk of complications with the more common complications being post-operative inflammation and post-operative pain.
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Includes appendices

Abstract: This systematic review and meta-analysis aim to review available information that addresses the question regarding the long-term efficacy in intraocular pressure (IOP) control and reduction, and the complication rates of Micropulse Transscleral Cyclophotocoagulation in patients with glaucoma. CENTRAL, PubMed and Google Scholar were used as data sources. Studies that include glaucoma patients who underwent MP-TSCPC with one year or more post-operative follow-up with data on pre-and post-operative IOP and complications were considered. NHLBI Quality Assessment Tool was used for the included studies. The treatment effect measures were (1) weighted mean difference (WMD) for the IOP reduction and, (2) proportions for the complication rate. Outcome measures were reported with a 95% confidence interval (CI) and P < 0.05 was considered statistically significant. Analysis was performed using Microsoft Excel and Open Meta Analysis software. In this systematic review, thirteen studies were included in total. Ten were case series, two were observational cohorts, and one randomized controlled trial. Risk of bias studies showed low to moderate risk among the included studies. In random effects model the pooled weighted mean difference was -13.649 (95% CI: {-16.350 - -10. 948], P < 0.001) showing statistically significant reduction in IOP after MP-TSCPC. Pooled proportion risk for complications was 0.418 (95% CI: [0.174 - 0.663], P < 0.001). And among the most common of these complications are the post- operative inflammation at 0.257 (95% CI: [0.094 - 0.420], P = 0.002) and post-operative pain at 0.039 (95% CI: [0.017 - 0.061], P <0.001). There is lack of high-quality evidence on the subject as only one RCT was retrieved. Our findings are based, therefore, mostly on case series and non-controlled observational studies. Our results showed that MP-TSCPC has good efficacy in reducing and controlling IOP after a year post-operatively. It is also safe with low risk of complications with the more common complications being post-operative inflammation and post-operative pain.

Research - Department of Ophthalmology

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