Beta radiation for glaucoma surgery

Kirwan, James; Rennie, Christina; Evans, Jennifer R

doi:10.1002/14651858.cd003433.pub2

Cited by 7 publications

(9 citation statements)

References 26 publications

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“…A previous systematic review has shown similar results (21) , however it was based on an extra study, which is not a RCT and has not been completely published yet (30) . In our analysis, a significant IOP reduction was observed in Black patients (P=0.005), however there is only a trend towards a significant difference for the IOP control in the Caucasian patients treated by BRT (P=0.05).…”

Section: Discussionmentioning

confidence: 68%

“…The effectiveness and safety of adjunct BRT in glaucoma surgery has not been adequately investigated because of small sample size, variable radiation doses and mixed patient groups (6,(14)(15)(16)(17)(18)(19)(20) . Recently a meta-analysis on this issue was published (21) , however in this study the authors did not evaluate the differences on IOP reduction among races, adverse effects as hypotony, hyphema, bleb leak and choroidal effusion. So, we decided to perform a systematic review and metaanalysis in order to analyze the efficacy and safety of TREC followed by beta irradiation (BRT/TREC) compared to TREC alone, including potential differences between distinct ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of beta radiation augmentation for trabeculectomy - results in distinct ethnic groups

Fendi

Arruda

Costa

et al. 2011

Arq. Bras. Oftalmol.

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RESUMO Objetivo: Realizar uma revisão sistemática com meta-análise sobre a eficácia da trabeculectomia (TREC), seguida ou não por irradiação beta (BRT/TREC) para o tratamento do glaucoma, em termos de controle da pressão intraocular (PIO) e de efeitos adversos citações, oito estudos (cinco coortes e três aleatorizados) foram identificados e apenas 3 RCT foram incluídos nesta meta-análise. Maiores reduções na PIO foram verificadas no braço de estudo da BRT, comparado com o braço controle (diferença média=1,68 mmHg, 95% CI= 0,61-2,68, P=0,002). A frequência de PIO pós-operatória não controlada (>21 mmHg) foi menor quando utilizada a BRT (BRT/TREC) em relação ao grupo controle (38/218 =17,4% versus 9/239 =3,8%;OR= 6,7 IC 95% 3,2 14,3, P<0,0001 ABSTRACTPurpose: To conduct a systematic review with meta-analysis on the efficacy of trabeculectomy (TREC) followed by beta irradiation (BRT/TREC) compared to TREC alone for glaucoma in terms of intraocular pressure (IOP) control and adverse effects of treatment in different ethnic groups. Methods: A meta-analysis of randomized controlled trials (RCT) was performed comparing adjunct BRT treatment for glaucoma with standard TREC after 12 months. The MEDLINE, EMBASE, LILACS, and Cochrane Library databases, Trial registers, bibliographic databases and recent studies of relevant journals were searched. Two reviewers independently reviewed relevant reports and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. Results: Of a total of 1,350 citations, eight studies (five cohorts, three randomized) were identified and only 3 RCT were included in this meta-analysis. Higher IOP reductions were verified in the BRT arm compared to the control arm (mean difference=1.68 mmHg, 95% CI= 0.61-2.68, P=0.002). Uncontrolled postoperative IOP (>21 mmHg) was less frequent when BRT was used (BRT/ TREC arm) compared to the control arm (38/218=17.4% versus 9/239=3.8%; OR=6.7; 95% CI 3.2-14.3, P<0.0001). Although better IOP control was observed in all patients treated with adjuvant BRT, only Black patients displayed a significant difference (P=0.005). There were no significant differences between the BRT and control arms regarding loss of visual acuity, postoperative complications and necessity of cataract surgery. Conclusion: Adjunct BRT increases the success rate of TREC, with better results in non Caucasian patients, and does not influence the occurrence of postoperative complications.

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Meta-analysis of beta radiation augmentation for trabeculectomy - results in distinct ethnic groups

Fendi

Arruda

Costa

et al. 2011

Arq. Bras. Oftalmol.

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“…Since its original description by Cairns in 1968 172 advances in operating microscopes, instruments, suture material and the introduction of antimetabolites have improved the success rates of trabeculectomy alongside a marked reduction in complications. 5,171,173,174…”

Section: Surgerymentioning

confidence: 99%

“…177 The success rate is lower in black Africans, people with previous ocular inflammation or vascularisation and children. 174 The commonest cause for failure of trabeculectomy is subconjunctival fibrosis 178 resulting in occlusion of the fistula with an encapsulated bleb, commonly known as the ‘ring of steel’. Various agents have been used to minimise scarring with mitomycin C (MMC) the most commonly used intra-operative agent.…”

Section: Surgerymentioning

confidence: 99%

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Clinical Options for the Reduction of Elevated Intraocular Pressure

et al. 2012

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Elevated IOP in clinical practice is usually seen in glaucoma or ocular hypertension. Glaucoma affects 60 million people worldwide and 8.4 million are bilaterally blind from this chronic disease.1 Options for reducing IOP rely on pharmacological agents, laser treatments and surgery which may be penetrating or non-penetrating. The last twenty years has seen significant changes in all of these strategies. This review aims to cover these clinical options and introduce some of the new technologies currently in development for the clinical lowering of IOP.

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