{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:45:15Z","timestamp":1790689515325,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T00:00:00Z","timestamp":1717891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This systematic review and meta\u2010analysis quantitatively examines the efficacy of angle\u2010based minimally invasive glaucoma surgery (MIGS) in normal tension glaucoma (NTG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature search was performed on Medline, Embase, PubMed, CINAHL and Cochrane Library from inception until 20 December 2022. Pilot, cohort, observational studies and randomised controlled trials including at least 5 subjects undergoing angle\u2010based MIGS (trabecular\u2010bypass devices, excisional trabeculotomy, goniotomy and ab\u2010interno canaloplasty) for NTG, with or without cataract surgery, were included. Meta\u2010analysis of continuous outcome using the meta routine in R version 2022.12.0+353 was performed to determine mean intraocular pressure (IOP) and anti\u2010glaucoma medication (AGM) reduction post\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 846 studies initially identified, 15 studies with a pooled total of 367 eyes which underwent combined phacoemulsification and angle\u2010based MIGS were included for final meta\u2010analysis. Outcomes of the iStent were reported in 5 studies, iStent inject in 7 studies, Hydrus Microstent in 1 study, Kahook Dual Blade in 3 studies, and Trabectome in 2 studies. There was significant reduction in both IOP and AGM post\u2010operatively at 6\u2009months (2.44\u2009mmHg, 95%CI: 1.83\u20133.06; 1.21 AGM, 95%CI: 0.99\u20131.44), 12\u2009months (2.28\u2009mmHg, 95%CI: 1.71\u20132.84; 1.18 AGM, 95%CI: 0.90\u20131.47), 24\u2009months (2.10\u2009mmHg, 95%CI: 1.51\u20132.68; 1.26 AGM, 95%CI: 0.85\u20131.68) and 36\u2009months (2.43\u2009mmHg, 95%CI: 1.71\u20133.15, 0.87 AGM, 95%CI: 0.21\u20131.53) (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Subgroup analysis on combined phacoemulsification\u2010iStent inject surgery demonstrated a reduction in both IOP (2.31\u2009mmHg, 95%CI: 1.07\u20133.56, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and AGM (1.07 AGM, 95%CI: 0.86\u20131.29, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) at 12\u2009months post\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Angle\u2010based MIGS combined with phacoemulsification effectively reduces IOP and AGM in NTG eyes for up to 36\u2009months after surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.14408","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T06:54:20Z","timestamp":1718002460000},"page":"740-760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Angle\u2010based minimally invasive glaucoma surgery in normal tension glaucoma: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2440-5128","authenticated-orcid":false,"given":"Hnin Hnin","family":"Oo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, National Healthcare Group Eye Institute Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley Shuen Ying","family":"Hong","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng Yang","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Healthcare Group Eye Institute Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan Chin Hou","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Healthcare Group Eye Institute Tan Tock Seng Hospital  Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Department of Ophthalmology, National Healthcare Group Eye Institute Woodlands Health  Singapore Singapore"},{"name":"Department of Ophthalmology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2005.081224"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/APO.0000000000000177"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2013.09.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(98)00272-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(84)90505-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.06.024"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.120.10.1268"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.932232"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/IJG.0000000000000145"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e32834ff1e7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/APO.0000000000000294"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2021.1903513"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2021.2351"},{"key":"e_1_2_9_15_1","unstructured":"Oxford Uo.OCEBM Levels of Evidence \u2014 Centre for Evidence\u2010Based Medicine (CEBM).2011Available from:https:\/\/www.cebm.ox.ac.uk\/resources\/levels\u2010of\u2010evidence\/ocebm\u2010levels\u2010of\u2010evidence"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"e_1_2_9_17_1","unstructured":"Team RC.R: A Language and Environment for Statistical Computing. 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