Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials
Purpose. The purpose of this meta-analysis was to assess the percent reduction in the intraocular pressure (IOP) after argon laser peripheral iridoplasty (ALPI) and systemic medical therapy in patients with acute primary angle closure (APAC). Methods. We searched a number of electronic databases, in...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2019/7697416 |
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| author | Wenting Cai Qiyang Lou Jiaqi Fan Donghui Yu Tianyi Shen Jing Yu |
| author_facet | Wenting Cai Qiyang Lou Jiaqi Fan Donghui Yu Tianyi Shen Jing Yu |
| author_sort | Wenting Cai |
| collection | DOAJ |
| description | Purpose. The purpose of this meta-analysis was to assess the percent reduction in the intraocular pressure (IOP) after argon laser peripheral iridoplasty (ALPI) and systemic medical therapy in patients with acute primary angle closure (APAC). Methods. We searched a number of electronic databases, including MEDLINE, EMBASE, PubMed, and Cochrane Library. We searched the electronic databases from the inception of the databases to August 2018. The primary outcomes included the IOP reduction (IOPR), percent reduction in IOP (IOPR%) from baseline to the endpoint and peripheral anterior synechiae (PAS). The secondary outcomes included the cup-to-disc ratio (CDR), mean endothelial count, and percent of patients requiring topical glaucoma medication. Summary weighted mean difference (WMD), odds ratio (OR), and 95% confidence intervals (CIs) were calculated. Results. Four eligible studies including 183 eyes (92 in the ALPI group and 91 in the medical therapy group) were identified. When comparing ALPI to medical therapy, the WMDs of the IOPR% were 30.03 (95% CI: 21.33 to 38.72, p<0.00001) at 15 minutes, 27.39 (95% CI: 18.89 to 35.89, p<0.00001) at 30 minutes, 18.15 (95% CI: 10.63 to 25.68, p<0.00001) at 1 hour, and 12.91 (95% CI: 4.50 to 21.32, p=0.003) at 2 hours. There was no statistically significant difference between the two groups at 24 hours and at more than 6 months after therapy. Meanwhile, no significant difference was observed in the degree of PAS, CDR, mean endothelial count, and percent of patients requiring topical glaucoma medication after treatment between the two groups. Conclusions. Both ALPI and systemic medications were effective with regard to decreasing the IOP. ALPI was more effective in lowering the IOP within the first two hours. Therefore, ALPI may be a better choice for rapidly lowering the IOP in patients with APAC within a short period. |
| format | Article |
| id | doaj-art-8da4252bde044b188849c5b54ff40a4f |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-8da4252bde044b188849c5b54ff40a4f2025-02-03T06:14:10ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/76974167697416Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled TrialsWenting Cai0Qiyang Lou1Jiaqi Fan2Donghui Yu3Tianyi Shen4Jing Yu5Department of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaDepartment of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaDepartment of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaDepartment of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaDepartment of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaDepartment of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, ChinaPurpose. The purpose of this meta-analysis was to assess the percent reduction in the intraocular pressure (IOP) after argon laser peripheral iridoplasty (ALPI) and systemic medical therapy in patients with acute primary angle closure (APAC). Methods. We searched a number of electronic databases, including MEDLINE, EMBASE, PubMed, and Cochrane Library. We searched the electronic databases from the inception of the databases to August 2018. The primary outcomes included the IOP reduction (IOPR), percent reduction in IOP (IOPR%) from baseline to the endpoint and peripheral anterior synechiae (PAS). The secondary outcomes included the cup-to-disc ratio (CDR), mean endothelial count, and percent of patients requiring topical glaucoma medication. Summary weighted mean difference (WMD), odds ratio (OR), and 95% confidence intervals (CIs) were calculated. Results. Four eligible studies including 183 eyes (92 in the ALPI group and 91 in the medical therapy group) were identified. When comparing ALPI to medical therapy, the WMDs of the IOPR% were 30.03 (95% CI: 21.33 to 38.72, p<0.00001) at 15 minutes, 27.39 (95% CI: 18.89 to 35.89, p<0.00001) at 30 minutes, 18.15 (95% CI: 10.63 to 25.68, p<0.00001) at 1 hour, and 12.91 (95% CI: 4.50 to 21.32, p=0.003) at 2 hours. There was no statistically significant difference between the two groups at 24 hours and at more than 6 months after therapy. Meanwhile, no significant difference was observed in the degree of PAS, CDR, mean endothelial count, and percent of patients requiring topical glaucoma medication after treatment between the two groups. Conclusions. Both ALPI and systemic medications were effective with regard to decreasing the IOP. ALPI was more effective in lowering the IOP within the first two hours. Therefore, ALPI may be a better choice for rapidly lowering the IOP in patients with APAC within a short period.http://dx.doi.org/10.1155/2019/7697416 |
| spellingShingle | Wenting Cai Qiyang Lou Jiaqi Fan Donghui Yu Tianyi Shen Jing Yu Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials Journal of Ophthalmology |
| title | Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | efficacy and safety of argon laser peripheral iridoplasty and systemic medical therapy in asian patients with acute primary angle closure a meta analysis of randomized controlled trials |
| url | http://dx.doi.org/10.1155/2019/7697416 |
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