Manual small incision cataract surgery combined with trabeculectomy versus phacoemulsification combined with trabeculectomy for coexisting glaucoma and cataract: a systematic review and meta-analysis

ABSTRACT

Background

Evaluate the efficacy and safety of manual small incision cataract surgery combined with trabeculectomy (MSICS-trab) compared to Phacoemulsification combined with trabeculectomy (phaco-trab), on the management of glaucoma and coexisting cataract.

Research design and methods

A systematic review and meta-analysis was realized following by PRISMA guideline recommendations and prospectively registered the study in PROSPERO (CRD42024504801). The PubMed, Web of Science, Cochrane, and Embase databases were searched for Randomized Clinical Trials (RCT) or non-RCT studies comparing MSICS-trab to phaco-trab on patients with coexisting glaucoma and cataracts. The mean difference with 95% confidence intervals was computed using a random-effects model. The statistical analysis was carried out using the RevMan software.

Results

Four studies were included with 568 patients, 283 (49.8%) received phaco-trab, while 285 (50.2%) received MSICS-trab. In the analysis of the MD of intraocular pressure at 1 week (p = 0.72), 1 month (p = 0.33), 12 months (p = 0.40), and at last visit (p = 0.69) there was no statistically significant difference between groups. A total of 150 complications were observed. Rates of general complications and serious complications were not significantly different between groups (p = 0.50).

Conclusions

MSICS-trab and phaco-trab showed sustained IOP reduction and without increasing complications.

KEYWORDS:

• Glaucoma
• cataract
• phacoemulsification
• trabeculectomy
• MISCS
• manual small incision cataract surgery

Declarations of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors made substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of relevant literature; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Data availability statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This paper was not funded.