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Meta-Analysis
. 2023 Oct 9;86(5):e20210353.
doi: 10.5935/0004-2749.2021-0353. eCollection 2023.

Anti-inflammatory treatment after selective laser trabeculoplasty: a systematic review of the literature and meta-analysis of randomized control trials

Dervenis Panagiotis  1   2 , Dervenis Nikolaos  3 , Chiras Dimitrios  4 , Vasilakis Panagiotis  2
Affiliations
Meta-Analysis

Anti-inflammatory treatment after selective laser trabeculoplasty: a systematic review of the literature and meta-analysis of randomized control trials

Dervenis Panagiotis et al. Arq Bras Oftalmol. .

Abstract
in English, Portuguese

We assessed the effects of anti-inflammatory treatment after selective laser trabeculoplasty through a systematic search of the MEDLINE, COCHRANE, and ClinicalTrials.gov. The outcome measures were intraocular pressure, anterior chamber inflammation, and discomfort. Evidence synthesis was performed using fixed effects or random-effects model according to the heterogeneity of the included studies. Heterogeneity was assessed using Q-statistic and I2. For an overall estimate of continuous outcomes, the mean differences and their 95% confidence intervals were applied, while odds ratios and their 95% confidence intervals were applied for dichotomous outcomes. Six studies were included in all. No significant difference was noted in the patients for intraocular pressure and discomfort when treated with anti-inflammatory drops. However, the patients showed benefit from reduced anterior chamber inflammation in the first postoperative week [FE OR=0.43, 95% CI=(0.19, 0.95), PQ=0.97, I2=0%], with no significant difference between the outcomes of non-steroidal anti-inflammatory drugs and steroids [FE OR=0.75, 95% CI=(0.20, 2.82), PQ=0.37, I2=0%]. Anti-inflammatory drops reduce anterior chamber inflammation after selective laser trabeculoplasty but showed no effect on the intraocular pressure.

O objetivo deste estudo é avaliar os efeitos do tratamento anti-inflamatório após a trabeculoplastia seletiva a laser. Uma busca sistemática foi feita no MEDLINE, COCHRANE e ClinicalTrials.gov. As medidas de resultado foram pressão intraocular, inflamação da câmara anterior e desconforto. A síntese de evidência foi realizada utilizando-se modelo de efeitos fixos ou efeitos aleatórios, de acordo com a heterogeneidade dos estudos incluídos. A heterogeneidade foi avaliada utilizando-se Q-statistic e I². Para uma estimativa global dos resultados contínuos, foram usadas diferenças médias e seus intervalos de confiança de 95% enquanto para resultados dicótomos, usou-se odds ratios e seus intervalos de confiança de 95%. Seis estudos foram incluídos. Nenhuma diferença significativa foi encontrada em pacientes tratados com gotas anti-inflamatórias em termos de pressão intraocular e desconforto. No entanto, eles se beneficiaram da redução da inflamação da câmara anterior na primeira semana pós-operatória [FE OR=0,43, IC 95% = (0,19, 0,95), PQ=0,97, I2=0%], sem diferença significativa entre anti-inflamatórios não esteroidais e esteroidais [FE OR=0,75, IC 95% = (0,20, 2,82), PQ=0,37, I2=0%]. Gotas anti-inflamatórias reduzem a inflamação da câmara anterior após trabeculoplastia seletiva a laser, não afetando a pressão intraocular.

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Conflict of interest statement

Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow chart depicting the literature search.
Figure 2
Figure 2
The summary of the risk of bias.
Figure 3
Figure 3
(A) IOP measurements 1 week after SLT-NSAID vs. Steroid. (B) IOP measurements 4-6 weeks after SLT-NSAID vs, Steroid.
Figure 4
Figure 4
(A) IOP measurements 1 week after SLT-anti-inflammatory vs. No treatment. (B) IOP measurements 4-6 weeks after SLT-anti-inflammatory vs. No treatment. (C) IOP measurements 3-4 months after SLT-anti-inflammatory vs. No treatment.
Figure 5
Figure 5
Mean reduction in IOP 12 weeks after SLT-anti-inflammatory vs. No treatment.
Figure 6
Figure 6
(A) AC inflammation 1 week after SLT-NSAID vs. Steroid. (B) AC inflammation 1 week after SLT-anti-inflammatory vs. No treatment. (C) AC inflammation 4-6 weeks after SLT-anti-inflammatory vs. No treatment.
Figure 7
Figure 7
(A) Discomfort/Pain 1 week after SLT-NSAID vs. Steroid. (B) Discomfort/Pain 1 week after SLT-anti-inflammatory vs. No treatment.
See this image and copyright information in PMC

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