Efficacy and safety of pilocarpine for the treatment of presbyopia: a systematic review and meta‑analysis of…

Meta-analysisScientific reports· Jul 2026

Efficacy and safety of pilocarpine for the treatment of presbyopia: a systematic review and meta‑analysis of randomized controlled trials.

Huimei Chen, Kai Wu, Juan Deng … Xiaolei Yao

Cataract & RefractiveMeta-analysisTreatmentQ1IF 5.0

Pilocarpine most improves near vision 3 hours after dosing versus placebo.

Efficacy and safety of pilocarpine for the treatment of presbyopia: a systematic review and meta‑analysis of randomized controlled trials.

Huimei Chen … Xiaolei Yao

Scientific reports · Jul 2026

Background

Pilocarpine, the first Food and Drug Administration-approved ophthalmic solution for presbyopia treatment, has garnered substantial attention owing to its therapeutic efficacy and safety profile.

Methods

Finally, a meta-analysis and Trial Sequential Analysis (Trial Sequential Analysis) were conducted.

Results

seeing print clearly up close 3 hours after treatment was far more likely

RR by subgroup · 95% CI

More results

Relevant literature published before April 1, 2025 can be retrieved from Web of Science, Embase, PubMed, and Cochrane Library.

More results

However, pilocarpine significantly increased the risk of participants experiencing ≥ 1 treatment-emergent adverse events (treatment-emergent adverse events), blurred vision, visual impairment, eye pain, headache, and nausea (P < 0.05) but had no significant effect on conjunctival hyperemia and instillation site pain (P > 0.05).

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Conclusion

Owing to the limited sample size, these findings warrant further validation through large-scale multicenter randomized controlled trials.

Efficacy and safety of pilocarpine for the treatment of presbyopia: a systematic review and meta‑analysis of randomized controlled trials.

Efficacy and safety of pilocarpine for the treatment of presbyopia: a systematic review and meta‑analysis of randomized controlled trials.

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