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Meta-Analysis
. 2012 Sep 12;2012(9):CD004399.
doi: 10.1002/14651858.CD004399.pub3.

Medical versus surgical interventions for open angle glaucoma

Jennifer Burr  1 , Augusto Azuara-Blanco, Alison Avenell, Anja Tuulonen
Affiliations
Meta-Analysis

Medical versus surgical interventions for open angle glaucoma

Jennifer Burr et al. Cochrane Database Syst Rev. .

Abstract

Background: Open angle glaucoma (OAG) is a common cause of blindness.

Objectives: To assess the effects of medication compared with initial surgery in adults with OAG.

Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2012), EMBASE (January 1980 to August 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2012), Biosciences Information Service (BIOSIS) (January 1969 to August 2012), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to August 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), Zetoc, the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 1 August 2012. The National Research Register (NRR) was last searched in 2007 after which the database was archived. We also checked the reference lists of articles and contacted researchers in the field.

Selection criteria: We included randomised controlled trials (RCTs) comparing medications with surgery in adults with OAG.

Data collection and analysis: Two authors independently assessed trial quality and extracted data. We contacted study authors for missing information.

Main results: Four trials involving 888 participants with previously untreated OAG were included. Surgery was Scheie's procedure in one trial and trabeculectomy in three trials. In three trials, primary medication was usually pilocarpine, in one trial it was a beta-blocker.The most recent trial included participants with on average mild OAG. At five years, the risk of progressive visual field loss, based on a three unit change of a composite visual field score, was not significantly different according to initial medication or initial trabeculectomy (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.54 to 1.01). In an analysis based on mean difference (MD) as a single index of visual field loss, the between treatment group difference in MD was -0.20 decibel (dB) (95% CI -1.31 to 0.91). For a subgroup with more severe glaucoma (MD -10 dB), findings from an exploratory analysis suggest that initial trabeculectomy was associated with marginally less visual field loss at five years than initial medication, (mean difference 0.74 dB (95% CI -0.00 to 1.48). Initial trabeculectomy was associated with lower average intraocular pressure (IOP) (mean difference 2.20 mmHg (95% CI 1.63 to 2.77) but more eye symptoms than medication (P = 0.0053). Beyond five years, visual acuity did not differ according to initial treatment (OR 1.48, 95% CI 0.58 to 3.81).From three trials in more severe OAG, there is some evidence that medication was associated with more progressive visual field loss and 3 to 8 mmHg less IOP lowering than surgery. In the longer-term (two trials) the risk of failure of the randomised treatment was greater with medication than trabeculectomy (OR 3.90, 95% CI 1.60 to 9.53; hazard ratio (HR) 7.27, 95% CI 2.23 to 25.71). Medications and surgery have evolved since these trials were undertaken.In three trials the risk of developing cataract was higher with trabeculectomy (OR 2.69, 95% CI 1.64 to 4.42). Evidence from one trial suggests that, beyond five years, the risk of needing cataract surgery did not differ according to initial treatment policy (OR 0.63, 95% CI 0.15 to 2.62).Methodological weaknesses were identified in all the trials.

Authors' conclusions: Primary surgery lowers IOP more than primary medication but is associated with more eye discomfort. One trial suggests that visual field restriction at five years is not significantly different whether initial treatment is medication or trabeculectomy. There is some evidence from two small trials in more severe OAG, that initial medication (pilocarpine, now rarely used as first line medication) is associated with more glaucoma progression than surgery. Beyond five years, there is no evidence of a difference in the need for cataract surgery according to initial treatment.The clinical and cost-effectiveness of contemporary medication (prostaglandin analogues, alpha2-agonists and topical carbonic anhydrase inhibitors) compared with primary surgery is not known.Further RCTs of current medical treatments compared with surgery are required, particularly for people with severe glaucoma and in black ethnic groups. Outcomes should include those reported by patients. Economic evaluations are required to inform treatment policy.

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Conflict of interest statement

JB has in the past received an educational grant from Pharmacia/Pfizer and support from Pharmacia and Allergan towards the cost of attendance at international meetings.

AAB has received honoraria for speaking at meetings, support for attending international meetings, educational grants and sponsorship for research from pharmaceutical companies, including Pharmacia/Pfizer, Allergan, Merck Sharpe & Dohme and Novartis.

AA ‐ none known.

AT has no research or educational grants from health care industry nor advisory board memberships. All international glaucoma meetings – with very few exceptions ‐ are supported directly or indirectly by companies in health care industry. The major sponsors of glaucoma meetings are Alcon, Allergan, Heidelberg Engineering, Merck Sharpe & Dohm, Pfizer and Santen. Direct support to AT has included occasional honoraria for speaking at meetings and reimbursement of travel costs.

Figures

1
1
Risk of bias summary: Review authors' judgements about each risk of bias item for the primary outcome for each included study.
1.1
1.1. Analysis
Comparison 1 Initial medical treatment versus Scheie's procedure, Outcome 1 Mean change in visual field score from baseline.
1.2
1.2. Analysis
Comparison 1 Initial medical treatment versus Scheie's procedure, Outcome 2 Mean change in IOP from baseline.
1.3
1.3. Analysis
Comparison 1 Initial medical treatment versus Scheie's procedure, Outcome 3 Mean change in VA score from baseline.
2.1
2.1. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 1 Progressive visual field loss.
2.2
2.2. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 2 Mean change in visual field score (Friedmann) from baseline. Moorfields PTT 1994 not ITT.
2.3
2.3. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 3 Mean difference in visual field score (mean deviation) at five years (unadjusted).
2.4
2.4. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 4 Mean difference in visual field scores (mean deviation) according to baseline severity at five years (adjusted).
2.5
2.5. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 5 Mean change in IOP from baseline.
2.6
2.6. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 6 Mean change in IOP from baseline (exploratory analysis with assumptions).
2.7
2.7. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 7 Mean difference in IOP up to 9 years.
2.8
2.8. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 8 Optic nerve progression at five years.
2.9
2.9. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 9 Medium to long‐term reduction of VA. CIGTS 2001 adjusted OR.
2.10
2.10. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 10 Failure of randomised treatment.
2.11
2.11. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 11 Time to failure of randomised treatment.
2.12
2.12. Analysis
Comparison 2 Initial medical treatment versus initial trabeculectomy, Outcome 12 Need for ALT as an additional treatment.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

CIGTS {published and unpublished data}
    1. Gillespie B, Musch D, Guire K, CIGTS Study group. History of intraocular pressure as a predictor of visual field progression in a randomized clinical trial of glaucoma treatment. Controlled Clinical Trials 2003;24:43S‐240S.
    1. Gillespie BW, Musch DC, Guire KE, Mills RP, Lichter PR, Janz NK, et al: CIGTS (Collaborative Initial Glaucoma Treatment) Study Group. The collaborative initial glaucoma treatment study: baseline visual field and test‐retest variability. Investigative Ophthalmology and Visual Science 2003;44(6):2613‐20. - PubMed
    1. Jampel HD, Frick KD, Janz NK, Wren PA, Musch DC, Rimal R, et al. CIGTS Study Group. Depression and mood indicators in newly diagnosed glaucoma patients. American Journal of Ophthalmology 2007;144(2):238‐44. - PubMed
    1. Jampel HD, Musch DC, Gillepsie BW, Lichter PR, Wright MM, Guire KE, Collaborative Initial Glaucoma Treatment Study Group. Perioperative complications of trabeculectomy in the collaborative initial glaucoma treatment study (CIGTS). American Journal of Ophthalmology 2005;140(1):16‐22. - PubMed
    1. Janz NK, Musch DC, Gillespie BW, Wren PA, Niziol LM, Collaborative Initial Glaucoma Treatment Study (CIGTS) Investigators. Evaluating clinical change and visual function concerns in drivers and nondrivers with glaucoma. Investigative Ophthalmology and Visual Science 2009;50(4):1718‐25. - PMC - PubMed
Glasgow Trial 1988 {published and unpublished data}
    1. Ainsworth JR, Jay JL. Cost analysis of early trabeculectomy versus conventional management in primary open angle glaucoma. Eye 1991;5(Pt 3):322‐8. - PubMed
    1. Jay J. Earlier trabeculectomy. Transactions of the Ophthalmological Societies of the United Kingdom 1983;103(Pt 1):35‐8. - PubMed
    1. Jay J. Rational choice of therapy in primary open angle glaucoma. Eye 1992;6(Pt 3):243‐7. - PubMed
    1. Jay J, Murdoch J. The rate of visual field loss in untreated primary open angle glaucoma. British Journal of Ophthalmology 1993;77(3):176‐8. - PMC - PubMed
    1. Jay J, Murray SB. Early trabeculectomy versus conventional management in primary open angle glaucoma. British Journal of Ophthalmology 1988;72(12):881‐9. - PMC - PubMed
Moorfields GT 1968 {published data only}
    1. Smith R. A comparison between medical and surgical treatment of glaucoma simplex‐results of a prospective study. Transactions of the Ophthalmological Society of Australia 1968;27:17‐29. - PubMed
    1. Smith R. A current study of the Moorfields glaucoma trial. Transactions of the Ophthalmological Societies of the United Kingdom 1970;90:861‐8. - PubMed
    1. Smith R. Medical versus surgical therapy in glaucoma patients. Documenta Ophthalmologica Proceedings Series 1977:123‐30.
    1. Smith R. The Lang Lecture 1986. The enigma of primary open angle glaucoma. Transactions of the Ophthalmological Societies of the United Kingdom 1986;105(Pt 6):618‐33. - PubMed
    1. Smith RJH. Medical versus surgical therapy in glaucoma simplex. British Journal of Ophthalmology 1972;56(3):277‐83. - PMC - PubMed
Moorfields PTT 1994 {published data only}
    1. Hitchings R, Migdal C, Fitke F. Intraocular pressure does it protect the Visual Fields?. Glaucoma Update IV. Berlin Heidelberg: Springer‐Verlag, 1991.
    1. Hitchings R, Migdal C, Gregory W, Poinooswamy D, Fitzke F. The use of the humphrey perimeter to identify visual loss. Annual Congress of Royal College of Ophthalmologists. May, 1993.
    1. Hitchings R, Migdal C, Wormald R, Poinooswamy D, Fitzke F. The primary treatment trial: changes in the visual field analysis by computer‐assisted perimetry. Eye 1994;8(Pt 1):117‐20. - PubMed
    1. McHam M, Migdal C, Netland P. Early trabeculectomy in the management of primary open angle glaucoma. International Ophthalmology Clinics 1994;34(3):163‐72. - PubMed
    1. Migdal C. What is the appropriate treatment for patients with primary open angle glaucoma: medicine, laser or primary surgery?. Ophthalmic Surgery 1995;26(2):108‐9. - PubMed

References to studies excluded from this review

Anand 2007 {published data only}
    1. Anand A, Negi N, Khokhar S, Kumar H, Gupta SK, Murthy GVS, et al. Role of early trabeculectomy in primary open‐angle glaucoma in the developing world. Eye 2007;21(1):40‐5. - PubMed
Dastur 1994 {published data only}
    1. Dastur YK. The role of early trabeculectomy in the control of chronic simple glaucoma. Journal of Postgraduate Medicine 1994;40(2):74‐7. - PubMed
Egbert 2001 {published data only}
    1. Egbert P, Fiadoyor S, Budenz DL, Dadzie, Byrad S. Diode laser transscleral cyclophotocoagulation as a primary surgical treatment for primary open angle glaucoma. Archives of Ophthalmology 2001;119(3):345‐50. - PubMed
Stewart 1996 {published data only}
    1. Stewart W, Sine C, LoPresto C. Surgical versus medical management of chronic open angle glaucoma. American Journal of Ophthalmology 1996;122(6):767‐74. - PubMed
Watson 1984 {published data only}
    1. Watson PG, Allen ED, Graham, CM, Porter GP, Pickering MS. Argon laser trabeculoplasty or trabeculectomy a prospective randomised block study. Transactions of the Ophthalmological Societies of the United Kingdom 1984;104(Pt 1):55‐61. - PubMed

Additional references

AAO 2000
    1. American Academy of Ophthalmology (AAO). Primary open‐angle glaucoma. Preferred Practice Pattern. American Academy of Ophthalmology (AAO). San Francisco (CA), 2000.
AGIS 2000
    1. Anonymous. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. American Journal of Ophthalmology 2000;130(4):429‐40. - PubMed
Bateman 2001
    1. Bateman DN, Clark R, Azuara‐Blanco A, Bain M, Forrest J. The impact of new drugs on management of glaucoma in Scotland: observational study. BMJ 2001;323(7326):1401‐2. - PMC - PubMed
Bateman 2002
    1. Bateman DN, Clark R, Azuara‐Blanco A, Bain M, Forrest J. The effects of new topical treatments on management of glaucoma in Scotland: an examination of ophthalmological health care. British Journal of Ophthalmology 2002;86(5):551‐4. - PMC - PubMed
Blondeau 1981
    1. Blondeau P, Phelps C. Trabeculectomy vs thermosclerostomy. A randomised prospective clinical trial. Archives of Ophthalmology 1981;99(5):810‐6. - PubMed
Bloom 1997
    1. Bloom PA, Tsai JC, Sharma K, Miller MH, Rice NS, Hitchings RA, et al. "Cyclodiode". Trans‐scleral diode laser cyclophotocoagulation in the treatment of advanced refractory glaucoma. Ophthalmology 1997;104(9):1508‐19. - PubMed
Bunce 2010
    1. Bunce C, Xing W, Wormald R. Causes of blind and partial sight certifications in England and Wales: April 2007‐March 2008. Eye 2010;24(11):1692‐9. - PubMed
Burr 2007
    1. Burr JM, Mowatt G, Hernandez R, Siddiqui MA, Cook J, Lourenco T, et al. The clinical effectiveness and cost‐effectiveness of screening for open angle glaucoma: a systematic review and economic evaluation. Health Technology Assessment 2007;11(41):iii‐iv, ix‐x, 1‐190. - PubMed
Cairns 1968
    1. Cairns JE. Trabeculectomy. Preliminary report of a new method. American Journal of Ophthalmology 1968;66(4):673‐9. - PubMed
Caprioli 2001
    1. Caprioli J, Maguire M. The "not quite" natural history of normal‐tension glaucoma. Ophthalmology 2001;108(2):245‐6. - PubMed
Chihara 1993
    1. Chihara E, Nishida A, Kodo M, Yoshimura N, Matsumura M, Yamamoto M, et al. Trabeculotomy ab externo: an alternative treatment in adult patients with primary open‐angle glaucoma. Ophthalmic Surgery 1993;24(11):735‐9. - PubMed
CNTGSG 1998
    1. Collaborative Normal‐Tension Glaucoma Study Group. Comparison of glaucomatous progression between untreated patients with normal‐tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal‐Tension Glaucoma Study Group. American Journal of Ophthalmology 1998;126(4):487‐97. - PubMed
Congdon 1992
    1. Congdon N, Wang F, Tielsch JM. Issues in the epidemiology and population‐based screening of primary angle‐closure glaucoma. Survey of Ophthalmology 1992;36(6):411‐23. - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Diggory 1995
    1. Diggory P, Cassels‐Brown A, Vail A, Abbey LM, Hillman JS. Avoiding unsuspected respiratory side‐effects of topical timolol with cardioselective or sympathomimetic agents. Lancet 1995;345(8965):1604‐6. - PubMed
Dreyer 1999
    1. Dreyer EB, Lipton SA. New perspectives on glaucoma. JAMA 1999;281(4):306‐8. - PubMed
Fechtner 1994
    1. Fechtner RD, Weinreb RN. Mechanisms of optic nerve damage in primary open angle glaucoma. Survey of Ophthalmology 1994;39(1):23‐42. - PubMed
Follmann 1992
    1. Follmann D, Elliot P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. Journal of Clinical Epidemiology 1992;45(7):769‐73. - PubMed
Fuchs 1992
    1. Fuchs J, Nissen KR, Goldschmidt E. Glaucoma blindness in Denmark. Acta Ophthalmologica 1992;70(1):73‐8. - PubMed
Gedde 2012
    1. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Treatment outcomes in the Tube Versus Trabeculectomy (TVT) study After five years of follow‐up. American Journal of Ophthalmology 2012;153(5):789‐803. - PMC - PubMed
Ghafour 1983
    1. Ghafour IM, Allan D, Foulds WS. Common causes of blindness and visual handicap in the west of Scotland. British Journal of Ophthalmology 1983;67(4):209‐13. - PMC - PubMed
Gillespie 2003
    1. Gillespie BW, Musch DC, Guire KE, Mills RP, Lichter PR, Janz NK, et al. CIGTS Study Group. The collaborative intial glaucoma treatment study: baseline visual field and test‐retest variability. Investigative Ophthalmology and Visual Science 2003;44(6):2613‐20. - PubMed
Glanville 2006
    1. Glanville JM, Lefebvre C, Miles JN, Camosso‐Stefinovic J. How to identify randomized controlled trials in MEDLINE: ten years on. Journal of the Medical Library Association 2006;94(2):130‐6. - PMC - PubMed
Gutierrez 1997
    1. Gutierrez P, Wilson MR, Johnson C, Gordon M, Cioffi GA, Ritch R, et al. Influence of glaucomatous visual field loss on health‐related quality of life. Archives of Ophthalmology 1997;115(6):777‐84. - PubMed
Heijl 2002
    1. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Archives of Ophthalmology 2002;120(10):1268‐79. - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hitchings 2004
    1. Hitchings RA, Migdal CS, Wormald R, Poinooswamy D, Fitzke F. The primary treatment trial: changes in the visual field analysis by computer‐assisted perimetry. Eye 1994;8(Pt 1):117‐20. - PubMed
Jacobi 2000
    1. Jacobi PC, Dietlein TS, Krieglstein GK. Perspectives in trabecular surgery. Eye 2000;14(Pt 3B):519‐30. - PubMed
Jampel 2005
    1. Jampel HD, Musch DC, Gillepsie BW, Lichter PR, Wright MM, Guire KE. Perioperative complications of trabeculectomy in the collaborative initial glaucoma treatment study group. American Journal of Ophthalmology 2005;140(1):16‐22. - PubMed
Jampel 2007
    1. Jampel HD, Frick KD, Janz NK, Wren PA, Musch DC, Rimal R, et al. Depression and mood indicators in newly diagnosed glaucoma patients. American Journal of Ophthalmology 2007;144(2):238‐44. - PubMed
Janz 2001
    1. Janz NK, Wren PA, Lichter PR, Musch DC, Gillespie BW, Guire KE, et al. The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. Ophthalmology 2001;108(11):1954‐65. - PubMed
Janz 2009
    1. Janz NK, Musch DC, Gillespie BW, Wren PA, Niziol LM, Collaborative Initial Glaucoma Treatment Study (CIGTS) Investigators. Evaluating clinical change and visual function concerns in drivers and nondrivers with glaucoma. Investigative Ophthalmology and Visual Science 2009;50(4):1718‐25. - PMC - PubMed
Jay 1988
    1. Jay J, Murray SB. Early trabeculectomy versus conventional management in primary open angle glaucoma. British Journal of Ophthalmology 1988;72(12):881‐9. - PMC - PubMed
Kass 2002
    1. Kass M, Heuer D, Higginbotham M, Johnson C, Keltner J, Miller J, et al. The Ocular Hypertension Treatment Study. A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open‐angle glaucoma. Archives of Ophthalmology 2002;120(6):701‐13. - PubMed
Kerrigan 1997
    1. Kerrigan LA, Zack DJ, Quigley HA, Smith SD, Pease ME. TUNEL‐positive ganglion cells in human primary open‐angle glaucoma. Archives of Ophthalmology 1997;115(8):1031‐5. - PubMed
Kirwan 2002
    1. Kirwan JF, Rennie C, Evans JR. Beta radiation for glaucoma surgery. Cochrane Database of Systematic Reviews 2012, Issue 6. [DOI: 10.1002/14651858.CD003433.pub3] - DOI - PMC - PubMed
Klaver 1998
    1. Klaver CC, Wolfs RC, Vingerling JR, Hofman A, Jong PT. Age‐specific prevalence and causes of blindness and visual impairment in an older population: the Rotterdam Study. Archives of Ophthalmology 1998;116(5):653‐8. - PubMed
Leske 1983
    1. Leske MC. The epidemiology of open‐angle glaucoma: a review. American Journal of Epidemiology 1983;118(2):166‐91. - PubMed
Lichter 2001
    1. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology 2001;108(11):1943‐53. - PubMed
Lim 1998
    1. Lim KS, Allan BD, Lloyd AW, Muir A, Khaw PT. Glaucoma drainage devices; past, present, and future. British Journal of Ophthalmology 1998;82(9):1083‐9. - PMC - PubMed
Migdal 1994
    1. Migdal C, Gregory W, Hitchings R. Long‐term functional outcome after early surgery compared with laser and medicine in open‐angle glaucoma. Ophthalmology 1994;101(10):1651‐6. - PubMed
Mills 2001
    1. Mills RP, Janz NK, Wren PA, Guire KE. Correlation of visual field with quality‐of‐life measures at diagnosis in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Journal of Glaucoma 2001;10(3):192‐8. - PubMed
Minckler 2006
    1. Minckler DS, Vedula SS, Li TJ, Mathew MC, Ayyala RS, Francis BA. Aqueous shunts for glaucoma. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD004918.pub2] - DOI - PMC - PubMed
Musch 1999
    1. Musch DC, Lichter PR, Guire KE, Standardi CL. The Collaborative Initial Glaucoma Treatment Study. Study design, methods and baseline characteristics of enrolled patients. Ophthalmology 1999;106(4):653‐62. - PubMed
Musch 2005
    1. Musch DC, Gillespie BW, Motyka BM, Niziol LM, Mills RP, Lichter PR. Converting to SITA‐standard from full‐threshold visual field testing in the follow‐up phase of a clinical trial. Investigative Ophthalmology and Visual Science 2005;46(8):2755‐9. - PubMed
Musch 2006
    1. Musch DC, Gillespie BW, Niziol LM, Janz NK, Wren PA, Rockwood EJ, et al. Cataract extraction in the collaborative initial glaucoma treatment study: incidence, risk factors, and the effect of cataract progression and extraction on clinical and quality‐of‐life outcomes. Archives of Ophthalmology 2006;124(12):1694‐1700. - PubMed
Musch 2008
    1. Musch DC, Gillespie BW, Niziol LM, Cashwell F, Lichter PR, Collaborative Initial Glaucoma Treatment Study Group. Factors associated with intraocular pressure before and during 9 years of treatment in the Collaborative Initial Glaucoma Treatment Study. Ophthalmology 2008;115(6):927‐33. - PMC - PubMed
Musch 2009
    1. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK, CIGTS Study Investigators. Visual field progression in the Collaborative Initial Glaucoma Treatment Study. The impact of treatment and baseline factors. Ophthalmology 2009;116(2):200‐7. - PMC - PubMed
Netland 2001
    1. Netland PA. Nonpenetrating glaucoma surgery. Ophthalmology 2001;108(2):416‐21. - PubMed
Parmar 1998
    1. Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta‐analyses of the published literature for survival endpoints. Statistics in Medicine 1998;17(24):2815‐34. - PubMed
Parrish 2009
    1. Parrish RK 2nd, Feuer WJ, Schiffman JC, Lichter PR, Musch DC, CIGTS Optic Disc Study Group. Five‐year follow‐up optic disc findings of the Collaborative Initial Glaucoma Treatment Study. American Journal of Ophthalmology 2009;147(4):717‐24. - PMC - PubMed
Quigley 1997
    1. Quigley HA, Vitale S. Models of open‐angle glaucoma prevalence and incidence in the United States. Investigative Ophthalmology and Visual Science 1997;38(1):83‐91. - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rolim de Moura 2007
    1. Rolim de Moura C, Paranhos A, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD003919.pub2] - DOI - PMC - PubMed
Rudnicka 2006
    1. Rudnicka AR, Mt‐Isa S, Owen CG, Cook DG, Ashby D. Variations in primary open‐angle glaucoma prevalence by age, gender, and race: a Bayesian meta‐analysis. Investigative Ophthalmology and Visual Science 2006;47(10):4254‐61. - PubMed
Sycha 2003
    1. Sycha T, Vass C, Findl O, Bauer P, Groke I, Schmetterer L, et al. Interventions for normal tension glaucoma. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD002222] - DOI - PubMed
Vass 2007
    1. Vass C, Hirn C, Sycha T, Findl O, Bauer P, Schmetterer L. Medical interventions for primary open angle glaucoma and ocular hypertension. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD003167.pub3] - DOI - PMC - PubMed
Watson 1981
    1. Watson PG, Grierson I. The place of trabeculectomy in the treatment of glaucoma. Ophthalmology 1981;88(3):175‐96. - PubMed
WHO 2002
    1. World Health Organization. Causes of blindness worldwide. http://www.who.int/en/ 2002.
Wilkins 2005
    1. Wilkins M, Indar A, Wormald R. Intraoperative Mitomycin C for glaucoma surgery. Cochrane Database of Systematic Reviews 2005, Issue 4. [DOI: 10.1002/14651858.CD002897.pub2] - DOI - PMC - PubMed
Wormald 2001
    1. Wormald R, Wilkins MR, Bunce C. Postoperative 5‐Fluorouracil for glaucoma surgery. Cochrane Database of Systematic Reviews 2001, Issue 3. [DOI: 10.1002/14651858.CD001132] - DOI - PubMed
Wren 2009
    1. Wren PA, Musch DC, Janz NK, Niziol LM, Guire KE, Gillespie BW. Contrasting the use of 2 vision‐specific quality of life questionnaires in subjects with open‐angle glaucoma. Journal of Glaucoma 2009;18(5):403‐11. - PMC - PubMed

References to other published versions of this review

Burr 2004
    1. Burr J, Azuara‐Blanco A, Avenell A. Medical versus surgical interventions for open angle glaucoma. Cochrane Database of Systematic Reviews 2004, Issue 2. [DOI: 10.1002/14651858.CD004399.pub2] - DOI - PubMed

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