What is the long-term efficacy and safety of selective laser trabeculoplasty in the management of primary open-angle glaucoma? A systematic review and meta-analysis
Notice bibliographique
Résumé
BACKGROUND: Selective laser trabeculoplasty (SLT) is a laser-based intervention used to lower intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG). It has been adopted as both a primary and adjunctive therapy, with growing interest in its long-term outcomes. This systematic review and meta-analysis aimed to assess the long-term efficacy and safety of SLT in adult patients with POAG, with a focus on sustained IOP control, reduction in medication burden, preservation of visual function, and adverse event incidence. METHODS: This review was conducted in accordance with PRISMA 2020 and MOOSE guidelines and was prospectively registered in PROSPERO (CRD420251030192). A systematic literature search was performed on June 16, 2025, across PubMed, Embase, Medline, and Scopus, including all records from database inception to the search date. Randomized controlled trials and observational studies reporting SLT outcomes with a minimum follow-up duration of 12 months were included. Primary outcomes included long-term IOP reduction and SLT failure rates. Secondary outcomes included medication use, visual field changes, and adverse events. Study quality was assessed using ROB-2 and Newcastle-Ottawa tools. Data were synthesized using random-effects models, and inter-study heterogeneity was quantified using the I² statistic. RESULTS: From 3462 identified records, 60 clinical studies were included for qualitative synthesis and 50 were included in the meta-analysis, representing a pooled sample of 8934 eyes. SLT achieved IOP reduction comparable to topical medications at 6-12 months post-treatment (mean difference: 0.04 mmHg; 95 % CI:0.27 to 0.34). Medication use significantly decreased following SLT (mean reduction:0.87 medications; 95 % CI:1.13 to -0.62). Visual field mean deviation improved by 0.79 dB (95 % CI: 0.76 to 0.82), and SLT was associated with minimal short-term IOP spikes. The health-related quality-of-life scores, as measured by EQ-5D, showed modest but consistent improvements. Risk of bias and publication bias were low in most domains. CONCLUSION: SLT demonstrated sustained long-term efficacy in reducing intraocular pressure and minimizing pharmacological burden in patients with POAG. It maintained visual function over extended follow-up and was associated with a favorable safety profile, including a low incidence of adverse events and IOP spikes. These findings support the use of SLT as an effective and safe long-term management option for POAG and justify its consideration as a first-line or adjunctive therapy in clinical practice.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,007 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».