Procedimientos ciclodestructivos para el glaucoma no refractario
Appendices
Appendix 1. CENTRAL search strategy
#1 MeSH descriptor Glaucoma
#2 glaucoma*
#3 MeSH descriptor Intraocular Pressure
#4 (ocular or intraocular or intra‐ocular) near/1 (pressure*)
#5 MeSH descriptor Ocular Hypertension, this term only
#6 ocular hypertension
#7 IOP or OHT
#8 (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7)
#9 MeSH descriptor Lasers
#10 laser*
#11 MeSH descriptor Laser Coagulation, this term only
#12 photocoagulat*
#13 photo near/1 coagulat*
#14 coagulat* or argon or diode
#15 ND YAG
#16 cyclophotocoagulat* or cyclodestruct*
#17 ciliary body destruct*
#18 (#9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17)
#19 (#8 AND #18)
Appendix 2. MEDLINE Ovid search strategy
1. randomized controlled trial.pt.
2. (randomized or randomised).ab,ti.
3. placebo.ab,ti.
4. dt.fs.
5. randomly.ab,ti.
6. trial.ab,ti.
7. groups.ab,ti.
8. or/1‐7
9. exp animals/
10. exp humans/
11. 9 not (9 and 10)
12. 8 not 11
13. exp glaucoma/
14. glaucoma$.tw.
15. exp intraocular pressure/
16. ((ocular or intraocular or intra‐ocular) adj1 pressure$).tw.
17. Ocular Hypertension/
18. ocular hypertension.tw.
19. (IOP or OHT).tw.
20. or/13‐19
21. exp lasers/
22. laser$.tw.
23. laser coagulation/
24. photocoagulat$.tw.
25. (photo adj1 coagulat$).tw.
26. (coagulat$ or argon or diode).tw.
27. ND YAG.tw.
28. (cyclophotocoagulat$ or cyclodestruct$).tw.
29. ciliary body destruct$.tw.
30. or/21‐29
31. 20 and 30
32. 12 and 31
The search filter for trials at the beginning of the MEDLINE strategy is from the published paper by Glanville 2006.
Appendix 3. Embase.com search strategy
1. exp randomized controlled trial/
2. exp randomization/
3. exp double blind procedure/
4. exp single blind procedure/
5. random$.tw.
6. or/1‐5
7. (animal or animal experiment).sh.
8. human.sh.
9. 7 and 8
10. 7 not 9
11. 6 not 10
12. exp clinical trial/
13. (clin$ adj3 trial$).tw.
14. ((singl$ or doubl$ or trebl$ or tripl$) adj3 (blind$ or mask$)).tw.
15. exp placebo/
16. placebo$.tw.
17. random$.tw.
18. exp experimental design/
19. exp crossover procedure/
20. exp control group/
21. exp latin square design/
22. or/12‐21
23. 22 not 10
24. 23 not 11
25. exp comparative study/
26. exp evaluation/
27. exp prospective study/
28. (control$ or prospectiv$ or volunteer$).tw.
29. or/25‐28
30. 29 not 10
31. 30 not (11 or 23)
32. 11 or 24 or 31
33. exp glaucoma/
34. glaucoma$.tw.
35. exp intraocular pressure/
36. ((ocular or intraocular or intra‐ocular) adj1 pressure$).tw.
37. exp intraocular hypertension/
38. ocular hypertension.tw.
39. (IOP or OHT).tw.
40. or/33‐39
41. exp lasers/
42. laser$.tw.
43. exp laser coagulation/
44. photocoagulat$.tw.
45. (photo adj1 coagulat$).tw.
46. (coagulat$ or argon or diode).tw.
47. ND YAG.tw.
48. (cyclophotocoagulat$ or cyclodestruct$).tw.
49. ciliary body destruct$.tw.
50. or/41‐49
51. 40 and 50
52. 32 and 51
Appendix 4. LILACS search strategy
glaucoma$ or intraocular pressure or ocular hypertension and laser$ or photocoagulat$ or cyclophotocoagulat$ or cyclodestruct$
Appendix 5. metaRegister of Controlled Trials search strategy
glaucoma and laser
Appendix 6. ClinicalTrials.gov search strategy
Glaucoma AND Laser
Study flow diagram.
| Low‐ versus high‐energy diode transscleralcyclophotocoagulation for non‐refractory glaucoma | ||||||
| Population: people with primary open‐angle glaucoma and no previous glaucoma surgery Settings: ophthalmology clinics Intervention: low energy; 1.5 watts for 1.5 seconds x 20 spots over 360 ° (45.0 J) Comparison: high energy; 1.25 watts for 2.5 seconds x 20 spots over 360 ° (62.5 J) | ||||||
| Outcomes* | Illustrative comparative risks** (95% CI) | Relative effect | No of participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| High‐energy diode transscleralcyclophotocoagulation | Low‐energy diode transscleralcyclophotocoagulation | |||||
| Control of intraocular pressure | 462 per 1000 | 475 per 1000 | RR 1.03 (0.64 to 1.65) | 79 | ⊕⊕⊝⊝ | Control of intraocular pressure defined as a decrease in IOP by 20% from baseline value |
| Mean change in intraocular pressure | On average intraocular pressure in the high energy group dropped by 3 mmHg | On average intraocular pressure in the low‐energy group was 0.5 mmHg lower than the IOP in the high‐energy group (5.79 mmHg lower to 4.79 mmHg higher) | ‐ | 79 | ⊕⊕⊝⊝ | ‐ |
| Decrease in visual acuity | 205 per 1000 | 250 per 1000 | RR 1.22 (0.54 to 2.76) | 79 | ⊕⊕⊝⊝ | Decrease in visual acuity defined as a decrease of 2 or more lines on the Snellen chart or one or more categories of visual acuity if unable to read the eye chart |
| Mean visual field | No visual field outcomes reported | ‐ | ‐ | ‐ | ‐ | ‐ |
| Number of glaucoma medications after treatment | The mean number of glaucoma medications in the high energy group was 1.3 | The mean number of glaucoma medications in the low energy group was 0.10 more (0.43 fewer to 0.63 more) | ‐ | 79 | ⊕⊕⊕⊝ | ‐ |
| Additional glaucoma surgery | 231 per 1000 | 175 per 1000 | RR 0.76 (0.31 to 1.84) | 79 | ⊕⊕⊝⊝ | Additional glaucoma surgery defined as retreatment with cyclophotocoagulation according to randomized assignment |
| Adverse events: atonic pupil | 311 per 1000 | 277 per 1000 | RR 0.89 (0.47 to 1.68) | 92 | ⊕⊕⊝⊝ | Atonic pupil was the only adverse event reported by treatment group. Trial authors noted that most participants had mild to moderate pain for a few days following the procedure and many also had transient conjunctival burns (number not reported). Severe iritis occurred in 2 eyes and hyphema occurred in 3 eyes. No instances of hypotony or phthisis bulbi were reported |
| *All outcomes are reported for participants with at least 3 months follow‐up; mean follow‐up was 13.2 months. | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded for risk of bias in the trial (unmasked outcome assessors and 14% attrition). | ||||||
