Background: The aim of this study was to compare the efficacy and tolerability of trabeculectomies performed\nwith and without releasable sutures in the treatment of patients with uncontrolled glaucoma.\nMethods: A comprehensive literature meta-analysis was performed, comparing trabeculectomies performed with and\nwithout releasable sutures. The primary efficacy measure was the weighted mean difference (WMD) in percentage\nintraocular pressure reduction (IOPR%) at the follow-up end point. The secondary efficacy measure was the risk\nratio (RR) for complete and qualified success rates of trabeculectomy at the follow-up end point. Trabeculectomy\ntolerability estimates were measured by the RR for adverse events. All the outcomes were reported with a 95%\nconfidence interval (CI).\nResults: The WMD of the IOPR% from baseline was -4.56 (range -9.24ââ?¬â??0.12) when trabeculectomies without\nreleasable sutures were compared with trabeculectomies with releasable sutures. Trabeculectomies with releasable\nsutures were associated with numerically greater, but nonsignificant, efficacy in terms of lowered IOP compared with\ntrabeculectomies without releasable sutures. The complete and qualified success rate of the two surgical procedures\nwere comparable, with RRs of 0.92 (range 0.80ââ?¬â??1.04) and 0.99 (range 0.89ââ?¬â??1.11), respectively, at the follow-up endpoints.\nTrabeculectomies without releasable sutures were associated with a significantly higher frequency of hypotony and flat\nanterior chambers than trabeculectomies with releasable sutures, with pooled RRs of 4.04 (range 1.88ââ?¬â??8.68) and 2.57\n(range 1.25ââ?¬â??5.30), respectively.\nConclusion: Although the two surgical procedures resulted in equivalent efficacy in IOP control, the trabeculectomies\nperformed with releasable sutures were better tolerated than those without releasable sutures.
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