Efficacy of Canaloplasty for the Management of Primary Open-Angle Glaucoma: Protocol for a Systematic Review
Bibliographic record
Abstract
Background Glaucoma forms the leading cause of irreversible blindness worldwide, with a disproportionately rising prevalence in Asian and African countries. Primary open-angle glaucoma (POAG) accounts for the majority of cases. Medical therapies for POAG are not without side effects, and surgical treatments carry high complication rates. Ab interno canaloplasty promises a safer, minimally invasive, yet effective treatment option for mild-to-moderate POAG, as well as a cost-effective technique for low-resource countries. However, no systematic review currently exists to verify this procedure’s efficacy. Objective The aim of this study was to develop a protocol for a systematic review aimed at evaluating the efficacy of canaloplasty against all other forms of POAG treatment. Methods This systematic review and meta-analysis will include randomized controlled trials evaluating the short-term, medium-term, and long-term efficacy and safety of ab interno canaloplasty in treating POAG in comparison to all other treatments. Mean changes in intraocular pressure will form the primary outcome measure. Secondary outcome measures include proportion of participants who are medication-free after treatment and mean changes in the health-related quality of life. MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases will be searched for relevant randomized controlled trials. All studies will be subject to prespecified inclusion and exclusion criteria. The quality of the eligible randomized controlled trials will be assessed using the Cochrane risk of bias tool. Data will be extracted with a focus on raw data where possible, and analysis will be performed using RevMan 5.4 software to compare the mean changes in intraocular pressure (mm Hg) between ab interno canaloplasty and other comparator therapies. A funnel plot will be used to assess the risk of publication bias if 10 or more trials are included in the review. I2 statistics will be used to assess heterogeneity. Sensitivity analysis will be conducted to exclude studies with a high risk of bias and, where possible, on the primary outcome. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach will be used to summarize the main findings. Results The results of this systematic review are not yet available as it is still at the protocol stage. This protocol was registered on the PROSPERO database for systematic reviews (CRD42024558671) on June 27, 2024. Data collection for this review began on July 14, 2024, with the anticipated completion date being early 2026. Conclusions The findings will be important to patients, clinicians, and policymakers worldwide in addressing the growing burden and health inequality of glaucoma. Trial Registration PROSPERO CRD42024558671; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024558671 International Registered Report Identifier (IRRID) PRR1-10.2196/69527
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.049 | 0.063 |
| Meta-epidemiology (narrow) | 0.005 | 0.004 |
| Meta-epidemiology (broad) | 0.020 | 0.023 |
| Bibliometrics | 0.012 | 0.010 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.007 | 0.008 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.051 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".