Título

MSICS COMBINED WITH TRABECULECTOMY VS. PHACOEMULSIFICATION WITH TRABECULECTOMY FOR GLAUCOMA & CATARACT: A META-ANALYSIS

Objetivo

Evaluate the efficacy and safety of manual small incision cataract surgery combined with trabeculectomy (MSICS-trab) compared to Phacoemulsification combined with trabeculectomy (phaco-trab), on the management of glaucoma and coexisting cataract.

Método

A systematic review and meta-analysis was realized following by PRISMA guideline and Cochrane Collaboration recommendations and prospectively registered the study in PROSPERO (CRD42024504801). The PubMed, Web of Science, Cochrane, and Embase databases were searched for Randomized Clinical Trials (RCT) or non-RCT studies comparing MSICS-trab to phaco-trab on patients with coexisting glaucoma and cataracts. The mean difference with 95% confidence intervals was computed using a random-effects model. The statistical analysis was carried out using the RevMan software. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD42024504801).

Resultado

Four studies were included with 568 patients, 283 (49.8%) received phaco-trab, while 285 (50.2%) received MSICS-trab. In the analysis of the MD of intraocular pressure at 1 week (p = 0.72), 1 month (p = 0.33), 12 months (p = 0.40), and at last visit (p = 0.69) there was no statistically significant difference between groups. A total of 150 complications were observed. Rates of general complications and serious complications were not significantly different between groups (p = 0.50).

Conclusão

MSICS combined with trabeculectomy and phacoemulsification combined with trabeculectomy emerged as effective treatments for the coexisting pathologies under investigation and showed sustained IOP reduction and without increasing complications. Our study revealed comparable efficacy and safety profiles for these procedures, with no statistical differences observed in postoperative IOP and complications. However, it's important to note that each technique has distinct advantages and indications, depending on personalized settings and conditions.