超声乳化联合IOL植入治疗闭角型青光眼合并白内障的疗效和安全性
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2014年荆州市医疗卫生科技计划项目(No.2014044)


Phacoemulsification combined with intraocular lens implantation versus trabeculectomy for angle-closure glaucoma with cataract: a meta-analysis
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Science and Technology Plan Project on Medicine and Public Health of Jingzhou 2014(No.2014044)

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    摘要:

    目的:系统性评价超声乳化联合人工晶状体(intraocular lens,IOL)植入与小梁切除术治疗闭角型青光眼合并白内障的疗效和安全性,为进一步探讨闭角型青光眼合并白内障的治疗方案提供更全面可靠的证据。

    方法:计算机检索自建库以来中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方全文数据库(WanFang)、中国科技期刊全文数据库(VIP)、Medline、EMBASE、Cochrane library,收集超声乳化联合IOL植入与小梁切除术治疗闭角型青光眼伴白内障的随机对照试验,采用Cochrane偏倚风险评估标准对纳入文献进行评估,采用Review Manager 5.3软件进行数据处理。

    结果:共纳入9篇文献,均为中文随机对照试验。Meta分析显示试验组(超声乳化联合IOL植入治疗)的术后并发症发生率低于对照组,差异有统计学意义(Z=4.32,P<0.0001); 两组患者术后1wk,1、3mo眼压比较,差异无统计学意义(P>0.05)。

    结论:两种手术方法均能使术后眼压降至正常,但超声乳化联合IOL植入的并发症发生率较低,安全性优于小梁切除术。

    Abstract:

    AIM: To systematically review and assess the efficacy and safety of phacoemulsification combined with intraocular lens(IOL)implantation versus trabeculectomy for angle closure glaucoma with cataract.

    METHODS: Databases including CNKI, CBM, WangFang, VIP, Medline, EMBASE, Cochrane library were searched to collect randomized controlled trails(RCTs)about phacoemulsification combined with intraocular lens implantation versus trabeculectomy. Cochrane collaboration's tool were used to assess the risk of bias of included studies and the meta-analysis was conducted by Revman 5.3 software.

    RESULTS: Nine eligible studies involving 696 patients were included. The results of meta-analysis shows that: there were no significant differences between two groups in postoperative intraocular pressure(P>0.05). While phacoemulsification combined with intraocular lens implantation has lower complications rate(Z=4.32, P<0.0001).

    CONCLUSION: Current evidence shows that phacoemulsification combined with intraocular lens implantation and trabeculectomy may has the similar efficacy for angle-closure glaucoma with cataract. But the former operation are more safer for patients.

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王金华,苏凡凡,陈乔,等.超声乳化联合IOL植入治疗闭角型青光眼合并白内障的疗效和安全性.国际眼科杂志, 2018,18(9):1599-1603.

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  • 收稿日期:2018-03-13
  • 最后修改日期:2018-08-07
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  • 在线发布日期: 2018-08-17
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