Objective To evaluate the efficacy and tolerability of nonpenetrating filtering surgery augmented with implant (NPFSI) compared with nonpenetrating filtering surgery without implant (NPFS) in the treatment of patients with open angle glaucoma.
Methods Pertinent studies were selected through extensive searches of the Cochrane Library, PubMed, Embase, and AAO and ARVO meeting abstracts. Seven controlled clinical trials meeting the pre-defined criteria were systematically reviewed by meta-analysis. The main outcome measures were percentage intraocular pressure (IOP) reduction, complete and qualified success rates. The pooled estimates were carried out in RevMan version 4.2 software.
Results The weighted mean difference of the percentage IOP reduction from baseline were 6.7% (95% confidence intervals, -3.8 to 17.2) when comparing NPFSI with NPFS. NPFSI was associated with numerically greater but nonsignificant IOP lowering efficacy than NPFS. The pooled risk differences comparing NPFSI with NPFS were 0.13 (-0.02 to 0.28) in complete success rate, and (-0.04 to 0.21) in qualified success rate. Numerically greater but nonsignificant proportions of NPFSI patients than NPFS patients achieved the target endpoint IOP. NPFSI resulted in the same incidences of postoperative complications as NPFS.
Conclusions NPFSI was associated with equivalent efficacy to standard NPFS in lowering IOP. Comparable proportions of patients reached the IOP target with NPFSI and NPFS. Both surgeries were well tolerated. |
