Short-term Efficacy and Safety of Ologen Collagen Matrix Implantation for Glaucoma Surgery: A Systematic Review and Network Meta-analysis

Importance This network meta-analysis was aimed to evaluate how Ologen will do when combined with different interventions for glaucoma patients. Objective To compare the effectiveness and safety of surgical treatments combined with Ologen and other commonly used treatments for glaucoma. Data Sources and Study Selection This network meta-analysis included randomized or non-randomized controlled trials and retrospective trials that compared interventions concerning Ologen and other treatments for glaucoma. The following databases were searched up to January 1, 2023: PubMed, Embase, Cochrane Library and Web of Science. Data Extraction and Synthesis Data extraction, quality and validity assessing were under the guidelines of 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses'. The demographic character of the included patients and outcomes was extracted independently by 2 investigators. Random-effects model was used to pool the estimate values. Mean outcomes and measures Mean differences for intraocular pressure reduction at 12 months postoperatively and the odds ratios for success rate at the end of follow-up time were the primary and secondary outcome. Measurement of outcomes were reported by 95% credibility intervals, and P < 0.05 was considered statistically significantly. Results This meta-analysis included 35 covering 2477 patients. We discussed 17 interventions, of which 10 had relevant outcomes in intraocular pressure reduction and 17 had relevant outcomes in success rate. When the intraocular pressure reduction was discussed, no pairwise comparison was statistically significant. While for success rate, pairwise comparisons that had statistically significant were detailed in the results and appendix section of this text. The best interventions are as follows: glaucoma drainage device combined with Ologen (success rate, surface under the cumulative ranking = 78.9) and trabeculectomy combined with Ologen (intraocular pressure reduction 12 mouths after surgery, surface under the cumulative ranking = 64). Adverse events were also calculated in details. Conclusion and Relevance Glaucoma drainage device combined with Ologen and trabeculectomy combined with Ologen are the most effective interventions for success rate and intraocular pressure reduction at 12 months postoperatively. However, more clinical studies are still in need to confirm this conclusion and to assess the long-term safety of these interventions. Trial Registration PROSPERO Identifier: CRD42023395804