Laser trabeculoplasty for open angle glaucoma

Show simple item record

dc.contributor.author Rolim, de Moura C.
dc.contributor.author Paranhos, A.
dc.contributor.author Wormald, R.
dc.date.accessioned 2016-01-24T12:41:42Z
dc.date.available 2016-01-24T12:41:42Z
dc.date.issued 2007-01-01
dc.identifier http://dx.doi.org/10.1002/14651858.CD003919.pub2
dc.identifier.citation Cochrane Database of Systematic Reviews. Chichester: John Wiley & Sons Ltd, n. 4, 36 p., 2007.
dc.identifier.issn 1469-493X
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/29350
dc.description.abstract BackgroundOpen angle glaucoma (OAG) is an important cause of blindness worldwide. Laser trabeculoplasty, a treatment modality, still does not have a clear position in the treatment sequence.ObjectivesThe objective of this review was to study the effects of laser trabeculoplasty for OAG.Search strategyWe identified trials from CENTRAL in the Cochrane Library, MEDLINE, EMBASE, LILACS and manual searching. We also contacted researchers in the field.Selection criteriaWe included randomised controlled trials comparing laser trabeculoplasty with no intervention, with medical treatment, or with surgery. We also included trials comparing different technical modalities of laser trabeculoplasty.Data collection and analysisTwo authors independently assessed trial quality and extracted the data. We contacted trial investigators for missing information.Main resultsThis review included 19 trials involving 2137 participants. Only five trials fulfilled the criteria of good methodological quality. One trial compared laser trabeculoplasty with topical beta-blocker to no intervention in early glaucoma. the risk of glaucoma progression was higher in the control group at six years of follow up ( risk ratio (RR) 0.71 95% confidence interval (CI) 0.53 to 0.95). No difference in health-related quality of life was observed between the two groups. Three trials compared laser trabeculoplasty to medication ( regimens used before the 1990s) in people with newly diagnosed OAG. the risk of uncontrolled intraocular pressure (IOP) was higher in the medication group compared to the trabeculoplasty group at six months and two years of follow up. Three trials compared laser trabeculoplasty with trabeculectomy. the risk of uncontrolled IOP was significantly higher in the trabeculoplasty group at six months but significant heterogeneity was observed at two years. Diode and selective laser are compared to argon laser trabeculoplasty in three trials and there is some evidence showing a comparable effect in controlling IOP at six months and one year of follow up.Authors' conclusionsEvidence suggests that, in people with newly diagnosed OAG, the risk of uncontrolled IOP is higher in people treated with medication used before the 1990s when compared to laser trabeculoplasty at two years follow up. Trabeculoplasty is less effective than trabeculectomy in controlling IOP at six months and two years follow up. Different laser technology and protocol modalities were compared to the traditional laser trabeculoplasty and more evidence is necessary to determine if they are equivalent or not. There is no evidence to determine the effectiveness of laser trabeculoplasty compared to contemporary medication ( prostaglandin analogues, topical anhydrase inhibitors and alpha2-agonists) and also with contemporary surgical techniques. Also there should be further investigation in to the effectiveness of laser trabeculoplasty in specific racial groups, specific diagnostic groups, such as pseudoexfoliation and pigmentary glaucoma and different stages of OAG. More research is also required determining cost-effectiveness of laser trabeculoplasty in the management of glaucoma. en
dc.format.extent 36
dc.language.iso eng
dc.publisher Wiley-Blackwell
dc.relation.ispartof Cochrane Database of Systematic Reviews
dc.rights Acesso restrito
dc.title Laser trabeculoplasty for open angle glaucoma en
dc.type Resenha
dc.rights.license http://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Universidade Federal de São Paulo, Escola Paulista Med, BR-04006 São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Escola Paulista Med, BR-04006 São Paulo, Brazil
dc.identifier.doi 10.1002/14651858.CD003919.pub2
dc.description.source Web of Science
dc.identifier.wos WOS:000250188700011



File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

Search


Browse

Statistics

My Account