Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Monali Malvankar

2nd Supervisor

Dr. Amardeep Thind

Joint Supervisor

Abstract

Purpose: To determine the efficacy of selective laser trabeculoplasty (SLT) in lowering intra-ocular pressure (IOP) levels and reducing the number of medications in patients with open angle glaucoma (OAG) or ocular hypertension (OHT).

Methods: A systematic review was conducted by searching various databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL, Cochrane Library, Web of Science- Core Collections, BIOSIS Previews, and Scopus. Duplicates were removed and articles were screened using EPPI Reviewer 4.0. A meta-analysis was conducted using STATA 13.0. Weighted mean difference (WMD) was computed and the heterogeneity statistic was assessed using the I2. Fixed and random effects models were computed based on heterogeneity.

Results: We identified 31 articles that met our inclusion criteria. We found that Sequential SLT versus pharmacotherapy had an IOP-lowering effect favoring pharmacotherapy: WMD= 5.92% (95% CI [3.06, 8.79]) and WMD= 2.73% (95% CI [0.24, 5.23]) at 6 and 12 months, respectively. Adjunctive SLT had a greater IOP-lowering effect compared to pharmacotherapy, WMD= -8.98% (95% CI [-17.19, -0.77]). A significant reduction in the post-operative medications was observed up to 17 months. No serious complications were reported.

Conclusion: Adjunctive SLT may lead to significant reduction in IOP compared to topical medications. Additional studies need to be conducted on SLT alone, without previous treatment in order to determine its IOP-lowering effect.

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