A meta‐analysis of surgical treatments for childhood glaucoma

Abstract

Aims/Purpose: To assess the comparative efficacies of surgical interventions for childhood glaucoma (CG).Methods: Through electronic database searches up to August 7, 2022, randomized controlled trials (RCTs) involving surgical interventions for CG were identified. A meta‐analysis was conducted to compare the surgical interventions: Conventional partial trabeculotomy ([CPT] control), 240‐degree trabeculotomy, Illuminated microcatheter‐assisted circumferential trabeculotomy (IMCT), Viscocanalostomy, Visco‐circumferential‐suture‐trabeculotomy, Goniotomy, Laser goniotomy, Kahook dual blade ab‐interno trabeculectomy, Trabeculectomy with mitomycin C, Trabeculectomy with modified scleral bed, Deep sclerectomy, Combined trabeculectomy‐trabeculotomy with mitomycin C, and Baerveldt implant. The main outcome measures were postoperative 6‐month mean intraocular pressure (IOP) reduction and surgical success rate. The mean differences (MDs) or odds ratios (ORs) were obtained using a random‐effects model, and the efficacies were ranked by P‐score.Results: Sixteen (16) RCTs were eligible for inclusion in the analysis, involving 710 eyes of 485 participants and 13 surgical interventions, which formed a 14‐node network. IMCT was superior to CPT in both IOP reduction (MD [95% CI], −3.10 [−5.50 to −0.69]) and surgical success rate (OR [95% CI], 4.38 [1.61 to 11.96]), while the MD and OR comparing the other surgical interventions with CPT were not statistically significant. Moreover, the IMCT was ranked as the most efficacious surgical intervention for success rate (P‐score = 0.777).Conclusions: This meta‐analysis revealed that IMCT is more effective than CPT and might be the most efficacious surgical intervention for CG.