Selective Laser Trabeculoplasty Outcomes in Phakic and Pseudophakic Patients: A Meta-Analysis

Rushil Kumbhani; Amanda Wong; Aretha Zhu; Paras Shah; Tristan Tham; Farihah Anwar; Daniel Zhu

doi:10.4103/joco.joco_285_23

Selective Laser Trabeculoplasty Outcomes in Phakic and Pseudophakic Patients: A Meta-Analysis

J Curr Ophthalmol. 2025 Jun 5;36(3):242-251. doi: 10.4103/joco.joco_285_23. eCollection 2024 Jul-Sep.

Authors

Rushil Kumbhani¹, Amanda Wong², Aretha Zhu³, Paras Shah¹, Tristan Tham^{4

5}, Farihah Anwar^{1

4}, Daniel Zhu^{1

4}

Affiliations

¹ Department of Ophthalmology, Northwell Health Eye Institute, Great Neck, NY, USA.
² Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
³ Department of Ophthalmology, The Institute of Ophthalmology and Vision Sciences, Rutgers New Jersey Medical School, Newark, NJ, USA.
⁴ Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.

Abstract

Purpose: To perform a meta-analysis to compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes.

Methods: Scopus, Embase, PubMed, and gray literature were searched for studies comparing SLT outcomes in phakic and pseudophakic patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). The mean change in intraocular pressure was compared using a standardized mean difference (SMD) meta-analysis (RevMan 5.4.1). Begg's funnel plots and Egger's test were used to assess publication bias.

Results: Eleven studies with 1058 eyes (323 pseudophakic and 735 phakic) were identified. There was no statistically significant difference in the observed efficacy of SLT between pseudophakic and phakic eyes (SMD = -0.10; 95% confidence interval = -0.24, 0.03; P = 0.14). There was no publication bias or heterogeneity (I ² = 0%; P = 0.66) detected. Subgroup analysis of studies stratified by length of follow-up in months (6, 12, and 24 or greater) revealed no significant difference in SLT efficacy at the different time points (P = 0.86, P = 0.59, and P = 0.16, respectively).

Conclusions: Our pooled and subgroup analysis revealed no significant difference in SLT response between the two populations. Our results support SLT as a viable treatment option for patients with OAG or OHT regardless of pseudophakic status.

Keywords: Meta-analysis; Ocular hypertension; Open-angle glaucoma; Phakic; Pseudophakic; Selective laser trabeculoplasty.

Publication types

Review