Título

PHACO-ENDOSCOPIC CYCLOPHOTOCOAGULATION VS PHACO ALONE IN THE GLAUCOMA TREATMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objetivo

We conducted a systematic review and meta-analysis comparing phaco-endoscopic cyclophotocoagulation (ECP) versus phacoemulsification alone, assessing the effectiveness and safety of outcomes in a population with glaucoma.

Método

The protocol for this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023482376). We systematically searched PubMed, Embase, and Web of Science from inception to December 2023. A random-effects model was used for all analyses due to heterogeneity. Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) was used for statistical analysis.

Resultado

Nine studies were included in this comprehensive review and a total of 5389 eyes were analyzed in our study. The mean age was 73.53 ± 2.60 years in the phaco-ECP group and 72.38 ± 3.63 years in the phaco arm. The number of eyes in the ECP + phaco was 806 and in the phaco alone 4583. In comparison to the ECP and phacoemulsification group, those receiving phacoemulsification alone showed better results in best-corrected visual acuity (MD 0.09; CI 95% 0.03 to 0.16; I2=0%), but worse outcomes in intraocular pressure (IOP) (MD -1.49; 95% CI -2.29 to -0.68; I2=29%) and use medications (MD -0.75; 95% CI -0.94 to -0.56; I2=0%) in the last visit. Complication rates, both general (OR 3.96; 95% CI 1.47 to 10.68; I2=68%) and serious (OR 8.82; 95% CI 5.70 to 13.65; I2=0%), were significantly different between the groups, indicating the potential impact of combined procedures on patient outcomes.

Conclusão

Thus, combining ECP with phacoemulsification for glaucoma treatment showed sustained IOP reduction and decreased medication dependence. However, higher complication rates suggest careful consideration of risks. More extensive research with larger trials and longer follow-ups is needed to validate findings and address limitations, providing valuable insights into this treatment approach.