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. 2016 Apr 18;9(4):597-603.
doi: 10.18240/ijo.2016.04.21. eCollection 2016.

Phacoemulsification versus combined phacotrabeculectomy in the treatment of primary angle-closure glaucoma with cataract: a Meta-analysis

Fang Wang  1 , Zhi-Hong Wu  1
Affiliations

Phacoemulsification versus combined phacotrabeculectomy in the treatment of primary angle-closure glaucoma with cataract: a Meta-analysis

Fang Wang et al. Int J Ophthalmol. .

Abstract

Aim: To compare the efficacy and safety of phacoemulsification (Phaco) against combined phacotrabeculectomy (Phacotrabe) in primary angle-closure glaucoma (PACG) with coexisting cataract.

Methods: By searching electronically the PubMed, EMBASE, Scientific Citation Index and Cochrane Library published up from inception to January 2014, all randomized controlled trials that matched the predefined criteria were included. The quality of included trials was evaluated according to the guidelines developed by the cochrane collaboration. And the outcomes estimating efficacy and safety of two different surgical treatments were measured and synthesised by RevMan 5.0.

Results: Five randomized controlled trials were selected and included in Meta-analysis with a total of 468 patients (468 eyes) with both PACG and cataract. We found that Phacotrabe had a greater intraocular pressure (IOP) lowing effect [preoperative IOP: weighted mean difference (WMD)=0.58, 95% confidence intervals (95% CI, -0.53 to 1.69), P=0.31; postoperative IOP: WMD=1.37, 95% CI (0.45 to 2.28), P=0.003], a lower number of anti-glaucoma medications [ risk ratio (RR) =0.05, 95% CI (0.02 to 0.18), P<0.00001] needed postoperatively and less serious damage of optic nerve [risk ratio (RR)=0.48, 95% CI (0.21 to 1.07), P=0.07], but a higher risk of complications [odds ratio (OR) =0.04, 95% CI (0.01 to 0.16), P<0.00001] compared with Phaco. The rest studies indicated that there had no significantly difference between the two surgical methods for postoperative best-corrected visual acuity (BCVA) [WMD=-0.05, 95% CI (-0.14 to 0.05), P=0.32] and loss of visual field [OR=1.06, 95% CI (0.61 to 1.83), P=0.83].

Conclusion: Phaco alone compared with Phacotrabe had a better effect in IOP reduction, whereas the security decline. Considering the number of sample size, our results remains to be further studied.

Keywords: Meta-analysis; cataract; phacoemulsificaton; phacotrabeculectomy; primary angle-closure glaucoma.

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Figures

Figure 1
Figure 1. Selection flowchart.
Figure 2
Figure 2. Forest plot of preoperative IOP.
Figure 3
Figure 3. Forest plot of postoperative IOP.
Figure 4
Figure 4. Forest plot of postoperative visual acuity.
Figure 5
Figure 5. Forest plot of postoperative glaucomatous drugs.
Figure 6
Figure 6. Forest plot of postoperative complications.
Figure 7
Figure 7. Forest plot of loss of visual filed.
Figure 8
Figure 8. Forest plot of damage of optic nerve.
See this image and copyright information in PMC

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