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Review
. 2017:2017:2965725.
doi: 10.1155/2017/2965725. Epub 2017 Jun 27.

When Is Evidence Enough Evidence? A Systematic Review and Meta-Analysis of the Trabectome as a Solo Procedure in Patients with Primary Open-Angle Glaucoma

Jeffrey T Y Chow  1 , Cindy M L Hutnik  2 , Karla Solo  1 , Monali S Malvankar-Mehta  1   2
Affiliations
Review

When Is Evidence Enough Evidence? A Systematic Review and Meta-Analysis of the Trabectome as a Solo Procedure in Patients with Primary Open-Angle Glaucoma

Jeffrey T Y Chow et al. J Ophthalmol. 2017.

Abstract

The purpose of this systematic review and meta-analysis was to examine the availability of evidence for one of the earliest available minimally invasive glaucoma surgery (MIGS) procedures, the Trabectome. Various databases were searched up to December 20, 2016, for any published studies assessing the use of the Trabectome as a solo procedure in patients with primary open-angle glaucoma (POAG). The standardized mean differences (SMD) were calculated for the change in intraocular pressure (IOP) and number of glaucoma mediations used at 1-month, 6-month, and 12-month follow-up. After screening, three studies and one abstract with analyzable data were included. The meta-analysis showed statistically significant reductions in IOP and number of glaucoma medications used at all time points. Though the Trabectome as a solo procedure appears to lower IOP and reduces the number of glaucoma medications, more high-quality studies are required to make definitive conclusions. The difficulty of obtaining evidence may be one of the many obstacles that limit a full understanding of the potential safety and/or efficacy benefits compared to standard treatments. The time has come for a thoughtful and integrated approach with stakeholders to determine optimal access to care strategies for our patients.

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Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Funnel plot for studies examining change in intraocular pressure (mmHg) by follow-up (months). The dashed line represents the confidence interval (CI).
Figure 3
Figure 3
Funnel plot for studies examining change in number of glaucoma medications used by follow-up (months). The dashed line represents the confidence interval (CI).
Figure 4
Figure 4
Forest plot for studies examining change in intraocular pressure (mmHg) by follow-up (months).
Figure 5
Figure 5
Forest plot for studies examining change in number of glaucoma medications used by follow-up (months).
See this image and copyright information in PMC

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