Laser trabeculoplasty for open XXXX .

@entity1 @entity1538 @entity726 @entity3009 @entity1939
BACKGROUND: @entity1538 ( @entity1538 ) is an important cause of @entity1939 worldwide. Laser trabeculoplasty, a treatment modality, still does not have a clear position in the treatment sequence. OBJECTIVES: The objective of this review was to study the effects of laser trabeculoplasty for @entity1538 . SEARCH STRATEGY: We identified trials from CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS and manual searching. We also contacted researchers in the field. SELECTION CRITERIA: We included randomised controlled trials comparing laser trabeculoplasty with no intervention, with medical treatment, or with surgery. We also included trials comparing different technical modalities of laser trabeculoplasty. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted the data. We contacted trial investigators for missing information. MAIN RESULTS: This review included 19 trials involving 2137 @entity1 . Only five trials fulfilled the criteria of good methodological quality. One trial compared laser trabeculoplasty with topical beta-blocker to no intervention in early @entity726 . The risk of @entity726 progression was higher in the control group at six years of follow up (risk ratio (RR) 0.71 95% confidence interval (CI) 0.53 to 0.95). No difference in health-related quality of life was observed between the two groups. Three trials compared laser trabeculoplasty to medication (regimens used before the 1990s) in @entity1 with newly diagnosed @entity1538 . The risk of uncontrolled intraocular pressure (IOP) was higher in the medication group compared to the trabeculoplasty group at six months and two years of follow up. Three trials compared laser trabeculoplasty with trabeculectomy. The risk of uncontrolled IOP was significantly higher in the trabeculoplasty group at six months but significant heterogeneity was observed at two years. Diode and selective laser are compared to argon laser trabeculoplasty in three trials and there is some evidence showing a comparable effect in controlling IOP at six months and one year of follow up. AUTHORS' CONCLUSIONS: Evidence suggests that, in @entity1 with newly diagnosed @entity1538 , the risk of uncontrolled IOP is higher in @entity1 treated with medication used before the 1990s when compared to laser trabeculoplasty at two years follow up. Trabeculoplasty is less effective than trabeculectomy in controlling IOP at six months and two years follow up. Different laser technology and protocol modalities were compared to the traditional laser trabeculoplasty and more evidence is necessary to determine if they are equivalent or not. There is no evidence to determine the effectiveness of laser trabeculoplasty compared to contemporary medication ( @entity3009 analogues, topical anhydrase inhibitors and alpha2-agonists) and also with contemporary surgical techniques. Also there should be further investigation in to the effectiveness of laser trabeculoplasty in specific racial groups, specific diagnostic groups, such as pseudoexfoliation and @entity1538 and different stages of @entity1538 . More research is also required determining cost-effectiveness of laser trabeculoplasty in the management of @entity726 .
