A Cochrane review [Abstract] 1 included 19 studies with a total of 2137 subjects. One trial compared laser trabeculoplasty with topical beta-blocker to no intervention in early glaucoma. The risk of glaucoma progression was higher in the control group at six years of follow. No difference in health-related quality of life was observed. In people with newly diagnosed open angle glaucoma (OAG) the risk of uncontrolled intraocular pressure (IOP) was higher in the medication group (regimens used before the 1990s) compared to the laser trabeculoplasty group at six months (RR 0.38, 95% CI 0.24 to 0.61; 2 studies, n=624) and two years of follow up (RR 0.80, 95% CI 0.71 to 0.91; 3 studies, n=735).
3 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 were compared to argon laser trabeculoplasty in 3 trials and there was some evidence showing a comparable effect in controlling IOP at six months and one year of follow up.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding), by inconsistency (heterogeneity in interventions and outcomes) and by indirectness (no comparisons with more recently introduced drugs)
Primary/Secondary Keywords