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Vol. 224, No. 3, 2010
Issue release date: April 2010

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Cheng J.-W. · Xi G.-L. · Wei R.-L. · Cai J.-P. · Li Y.
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Abstract

Aims:To evaluate the efficacy and tolerability of nonpenetrating filtering surgery in the treatment of patients with open-angle glaucoma. Methods: Pertinent studies were selected by extensive searches. A total of 17 randomized controlled trials were included in the present meta-analysis. The main outcome measures were risk differences (RDs) of complete success for efficacy and postoperative complications for tolerability. Pooled estimates were computed according to a random-effects model. Results:Viscocanalostomy and deep sclerectomy were significantly less effective than tra- beculectomy, and pooled RDs of complete success were –0.16 (95% confidence interval, CI, –0.30 to –0.02) and –0.10 (–0.19 to 0.00). Deep sclerectomy plus mitomycin C (MMC) was also less effective than trabeculectomy plus MMC, with pooled RD of complete success being –0.16 (95% CI –0.32 to –0.01). Viscocanalostomy and deep sclerectomy caused main complications in fewer patients than trabeculectomy. Conclusions:Viscocanalostomy and deep sclerectomy were less effective than trabeculectomy in the treatment of open-angle glaucoma, and deep sclerectomy plus MMC was also less effective than trabeculectomy plus MMC. However, viscocanalostomy and deep sclerectomy were associated with fewer complications than trabeculectomy.



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References

  1. Zimmerman TJ, Kooner KS, Ford VJ, et al: Effectiveness of nonpenetrating trabeculectomy in aphakic patients with glaucoma. Ophthalmic Surg 1984;15:44–50.
  2. Demailly P, Lavat P, Kretz G, Jeanteur-Lunel MN: Non-penetrating deep sclerectomy (NPDS) with or without collagen device (CD) in primary open-angle glaucoma: middle-term retrospective study. Int Ophthalmol 1997;20:131–140.
  3. Sanchez E, Schnyder CC, Sickenberg M, et al: Deep sclerectomy: results with and without collagen implant. Int Ophthalmol 1997;20:157–162.
  4. Carassa RG, Bettin P, Fiori M, Brancato R: Viscocanalostomy: a pilot study. Eur J Ophthalmol 1998;8:57–61.
  5. Massy J, Gruber D, Muraine M, Brasseur G: Non-penetrating deep sclerectomy in the surgical treatment of chronic open-angle glaucoma: mid-term results (in French). J Fr Ophtalmol 1999;22:292–298.
  6. Stegmann R, Pienaar A, Miller D: Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg 1999;25:316–322.
  7. Karlen ME, Sanchez E, Schnyder CC, et al: Deep sclerectomy with collagen implant: medium term results. Br J Ophthalmol 1999;83:6–11.
  8. Hamard P, Plaza L, Kopel J, et al: Deep nonpenetrating sclerectomy and open angle glaucoma: intermediate results from the first operated patients. J Fr Ophtalmol 1999;22:25–31.
  9. Shaarawy T, Karlen M, Schnyder C, et al: Five-year results of deep sclerectomy with collagen implant. J Cataract Refract Surg 2001;27:1770–1778.
  10. Drusedau MU, von Wolff K, Bull H, von Barsewisch B: Viscocanalostomy for primary open-angle glaucoma: the Gross Pankow experience. J Cataract Refract Surg 2000;26:1367–1373.
  11. Sunaric-Megevand G, Leuenberger PM: Results of viscocanalostomy for primary open-angle glaucoma. Am J Ophthalmol 2001;132:221–228.
  12. Jadad AR, Moore RA, Carroll D, et al: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12.
  13. DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986;7:177–188.
  14. Higgins JP, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. BMJ 2003;327:557–560.
  15. Cook RJ, Sackett DL: The number needed to treat: a clinically useful measure of treatment effect. BMJ 1995;310:452–454.
  16. Mermoud A, Schnyder CC, Sickenberg M, et al: Comparison of deep sclerectomy with collagen implant and trabeculectomy in open-angle glaucoma. J Cataract Refract Surg 1999;25:323–331.
  17. Spinelli D, Curatola MR, Faroni E: Comparison between deep sclerectomy with reticulated hyaluronic acid implant and trabeculectomy in glaucoma surgery. Acta Ophthalmol Scand 2000;78(suppl):60–62.
  18. Jonescu-Cuypers C, Jacobi P, Konen W, Krieglstein G: Primary viscocanalostomy versus trabeculectomy in white patients with open-angle glaucoma: a randomized clinical trial. Ophthalmology 2001;108:254–258.
  19. Ambresin A, Shaarawy T, Mermoud A: Deep sclerectomy with collagen implant in one eye compared with trabeculectomy in the other eye of the same patient. J Glaucoma 2002;11:214–220.
  20. Schnyder CC, Shaarawy T, Ravinet E, et al: Free conjunctival autologous graft for bleb repair and bleb reduction after trabeculectomy and nonpenetrating filtering surgery. J Glaucoma 2002;11:10–16.
  21. Egrilmez S, Ates H, Nalcaci S, et al: Surgically induced corneal refractive change following glaucoma surgery: nonpenetrating trabecular surgeries versus trabeculectomy. J Cataract Refract Surg 2004;30:1232–1239.
  22. Yarangumeli A, Gureser S, Koz OG, et al: Viscocanalostomy versus trabeculectomy in patients with bilateral high-tension glaucoma. Int Ophthalmol 2004;25:207–213.
  23. Detry-Morel M, Pourjavan S, Detry MB: Comparative safety profile between ‘modern’ trabeculectomy and non-penetrationg deep sclerectomy (in French). Bull Soc Belge Ophtalmol 2006;300:43–54.

    External Resources

  24. Cillino S, Di Pace F, Casuccio A, Lodato G: Deep sclerectomy versus punch trabeculectomy: effect of low-dosage mitomycin C. Ophthalmologica 2005;219:281–286.
  25. Chiou AG, Mermoud A, Jewelewicz DA: Post-operative inflammation following deep sclerectomy with collagen implant versus standard trabeculectomy. Graefes Arch Clin Exp Ophthalmol 1998;236:593–596.
  26. El Sayyad F, Helal M, El-Kholify H, et al: Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open-angle glaucoma. Ophthalmology 2000;107:1671–1674.
  27. Chiselita D: Non-penetrating deep sclerectomy versus trabeculectomy in primary open-angle glaucoma surgery. Eye 2001;15:197–201.
  28. Lüke C, Dietlein TS, Jacobi PC, et al: A prospective randomized trial of viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study. J Glaucoma 2002;11:294–299.
  29. O’Brart DP, Rowlands E, Islam N, Noury AM: A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy. Br J Ophthalmol 2002;86:748–754.
  30. Wang N, Wu H, Ye T, et al: Analysis of intra-operative and early post-operative complications and safety in non-penetrating trabecular surgery. Zhonghua Yan Ke Za Zhi 2002;38:329–334.

    External Resources

  31. Carassa RG, Bettin P, Fiori M, Brancato R: Viscocanalostomy versus trabeculectomy in white adults affected by open-angle glaucoma: a 2-year randomized, controlled trial. Ophthalmology 2003;110:882–887.
  32. Kobayashi H, Kobayashi K, Okinami S: A comparison of the intraocular pressure-lowering effect and safety of viscocanalostomy and trabeculectomy with mitomycin C in bilateral open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2003;241:359–366.
  33. Cillino S, Pace FD, Casuccio A, et al: Deep sclerectomy versus punch trabeculectomy with or without phacoemulsification: a randomized clinical trial. J Glaucoma 2004;13:500–506.
  34. O’Brart DP, Shiew M, Edmunds B: A randomised, prospective study comparing trabeculectomy with viscocanalostomy with adjunctive antimetabolite usage for the management of open angle glaucoma uncontrolled by medical therapy. Br J Ophthalmol 2004;88:1012–1017.
  35. Schwenn O, Springer C, Troost A, et al: Deep sclerectomy using a hyaluronate implant versus trabeculectomy: a comparison of two glaucoma operations using mitomycin C. Ophthalmologe 2004;101:696–704.
  36. Yalvac IS, Sahin M, Eksioglu U, et al: Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma: three-year prospective randomized clinical trial. J Cataract Refract Surg 2004;30:2050–2057.
  37. Huang Y, Wang NL, Wang BW, Li LJ: The long term curative effect of the nonpenetrating trabecular surgery. Yan Ke 2006;15:277–280.
  38. Cillino S, Di Pace F, Casuccio A, et al: Deep sclerectomy versus trabeculectomy with low-dosage mitomycin C: four-year follow-up. Ophthalmologica 2008;222:81–87.
  39. Johnson DH, Johnson M: Glaucoma surgery and aqueous outflow: how does nonpenetrating glaucoma surgery work? Arch Ophthalmol 2002;120:67–70.
  40. Kozobolis VP, Christodoulakis EV, Tzanakis N, et al: Primary deep sclerectomy versus primary deep sclerectomy with the use of mitomycin C in primary open-angle glaucoma. J Glaucoma 2002;11:287–293.
  41. Neudorfer M, Sadetzki S, Anisimova S, Geyer O: Nonpenetrating deep sclerectomy with the use of adjunctive mitomycin C. Ophthalmic Surg Lasers Imaging 2004;35:6–12.


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