ArticleJournal of current glaucoma practice
What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic Review.
Article in Journal of current glaucoma practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors at 4 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
AIM AND
objectiveThis study aimed to use the available evidence to model a glaucoma surgical rate (GSR), which could serve as a target for West Africa. MATERIALS AND
methodsA comprehensive literature search was performed in Medline, Embase, Global Health, and CINAHL, and studies published between January 1, 2000, and June 19, 2020, were retrieved. Study selection, quality appraisal, and data extraction were performed and the results of individual studies aggregated and presented using a narrative synthesis. Using these data, we aimed to construct a target GSR per million population per year that is sufficient to offer trabeculectomy to most patients with glaucoma who are diagnosed, and for whom other treatment options are either ineffective or inappropriate. The findings were then used to develop a trabeculectomy target for West Africa.
resultsInitial searches returned 633 references, of which 33 unique studies were eligible for inclusion. The glaucoma prevalence population-based surveys identified, reported a wide range of prevalence of primary open-angle glaucoma (POAG) ranging from 1.0 to 8.4%. The studies on glaucoma medications reported intraocular pressure (IOP)-lowering effects ranging from 12.8% (beta-blockers) to 63.7% (Timolol-Latanoprost combinations). The adherence rate to antiglaucoma medications spanned from 10.3 to 82.3%. Regarding selective laser trabeculoplasty (SLT), only two studies were found. All the studies on trabeculectomy showed a significant reduction in IOPs at different follow-up periods with many reporting the absence of vision-threatening complications. From these available data, a GSR of 50 trabeculectomies was suggested for countries in West Africa.
conclusionThis trabeculectomy target metric is expected to minimize POAG blindness in the West African subregion. CLINICAL SIGNIFICANCE: The proposed GSR will enable eye care workers involved in glaucoma care in West Africa to assess their efforts compared with the proposed target. The gap will signal the potential for improvement. HOW TO CITE THIS ARTICLE: Eni EN, Nolan W, Eval B,
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