A System Review and Meta-Analysis of Canaloplasty Outcomes in Glaucoma Treatment in Comparison with Trabeculectomy

Abstract

Purpose. This system review studied the efficiency and safety of canaloplasty (CP) and compared the outcomes between CP and trabeculectomy (TE). Methods. Literatures were searched in PubMed and EMBASE. The meta-analysis was conducted on the postoperative outcomes in CP and then on the differences of outcomes between CP and TE. Results. In the meta-analysis, IOP decreased by 9.94 (95% CI 8.42 to 11.45) mmHg with an average AGM reduction of 2.11 (95% CI 1.80 to 2.42) one year after CP. The IOP reduction was significantly higher after TE than after CP, with an average difference of 3.61 (95% CI 1.69 to 5.53) mmHg at 12 months postoperationally. For complications, the incidence of hyphema was significantly higher in CP and the Descemet membrane detachment was just reported in CP, with an incidence of 3%. However, the incidence was significantly lower in CP of hypotony and of choroidal effusion/detachment. Meanwhile, suprachoroidal hemorrhage and bleb needling were only reported in TE. Conclusions. CP was less effective in IOP reduction than TE, but CP was able to achieve similar postoperative success rates and reduce the number of AGMs likewise. CP was also associated with lower incidence of complications. More high-quality researches are needed in the future to verify our findings in this system review.

Figure 1

Flow diagram for study selection.

Figure 2

Comparison of the reductions in IOP and antiglaucoma medications (AGMs) between canaloplasty (CP) and trabeculectomy (TE) (PCP = phacocanaloplasty, PTE = phacotrabeculectomy).

Figure 3

Comparison of success rates between canaloplasty (CP) and trabeculectomy (TE) (independent CP versus TE in Matlach et al. [22] and Thederan et al. [26]; PCP versus PTE in Matlach [31]; PCP = phacocanaloplasty, PTE = phacotrabeculectomy).

Figure 4

Comparison of complications between canaloplasty (CP) and trabeculectomy (TE).