Efficiency and safety of argon laser in trichiasis: A systematic review and meta-analysis

To conduct a systematic review and meta-analysis evaluating the efficacy and safety outcomes of argon laser treatment for trichiasis, a common eye condition that can lead to blindness. We conducted a systematic review and meta-analysis. PubMed, Cochrane Library, Science Direct, Embase, and ClinicalTrials.gov databases were searched for studies on argon laser treatment of trichiasis, without language restriction, up to March 2025. We computed random-effect meta-analysis and meta-regressions on putative influencing factors. The PRISMA guidelines were followed. The meta-analysis was registered on PROSPERO (ID: CRD42024546074). Twenty-seven articles were included in the systematic review, and 20 in the meta-analysis, for a total of 1044 patients. The prevalence of trichiasis recurrence at the end of follow-up was 4.1% (95% CI 2.7 to 5.5%), ranging from 0% to 37.7%, reflecting substantial heterogeneity between studies (I2 91.5%). After only one session, the prevalence of trichiasis recurrence was 35.8% (25.9 to 45.7%, I2 91.5%). The prevalence of lid complications was 0.1% (-0.2 to 0.5%). Reported complications included notching (0.1%; 95% CI, -0.2% to 0.5%), hypopigmentation (0.0%; 95% CI, -0.1% to 0.2%), and rash (0.0%; 95% CI, -0.3% to 0.3%). The prevalence of pain was 0.0% (-0.1 to 0.2%). The certainty of the evidence was assessed using the GRADE approach, and most outcomes were rated as low certainty due to limitations in study design and heterogeneity. Argon laser for trichiasis is an effective procedure, but several sessions may be necessary. The safety profile of this technique is very good with few and mild complications.