Efficacy and tolerability of nonpenetrating filtering surgery in the treatment of open-angle glaucoma: a meta-analysis.

AIMS To evaluate the efficacy and tolerability of nonpenetrating filtering surgery in the treatment of patients with open-angle glaucoma. METHODS Pertinent studies were selected by extensive searches. A total of 17 randomized controlled trials were included in the present meta-analysis. The main outcome measures were risk differences (RDs) of complete success for efficacy and postoperative complications for tolerability. Pooled estimates were computed according to a random-effects model. RESULTS Viscocanalostomy and deep sclerectomy were significantly less effective than tra- beculectomy, and pooled RDs of complete success were -0.16 (95% confidence interval, CI, -0.30 to -0.02) and -0.10 (-0.19 to 0.00). Deep sclerectomy plus mitomycin C (MMC) was also less effective than trabeculectomy plus MMC, with pooled RD of complete success being -0.16 (95% CI -0.32 to -0.01). Viscocanalostomy and deep sclerectomy caused main complications in fewer patients than trabeculectomy. CONCLUSIONS Viscocanalostomy and deep sclerectomy were less effective than trabeculectomy in the treatment of open-angle glaucoma, and deep sclerectomy plus MMC was also less effective than trabeculectomy plus MMC. However, viscocanalostomy and deep sclerectomy were associated with fewer complications than trabeculectomy.