闭角型青光眼合并白内障两种手术方式比较的Meta分析
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Comparison between two surgeries for angle-closure glaucoma combined with cataract: a Meta-analysis
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    摘要:

    目的:系统评价超声乳化白内障摘除联合房角粘连分离术或联合小梁切除术治疗原发性闭角型青光眼合并白内障的疗效比较。

    方法:计算机检索PubMed、Science direct、CNKI学术总库、维普中文科技期刊数据库、万方数据库,收集国内外 2000-01/2015-02发表或收录的超声乳化白内障摘除联合房角粘连分离术与超声乳化白内障摘除联合小梁切除术治疗原发性闭角型青光眼的随机对照临床试验(RCT)。临床评价包括治疗后眼压降低幅度、视力改善、中央前房深度变化、房角开放程度、手术成功率、术后并发症情况。采用Revman5.0软件进行Meta分析。

    结果:按照文献纳入和排除标准,经筛选后最终纳入Meta分析的文献5篇,共492例患者。Meta分析结果显示:超声乳化白内障摘除联合小梁切除术后眼压降低幅度更大\,超声乳化白内障摘除联合房角粘连分离术后房角开放程度更优、中央前房深度加深更多\; 两种手术视力改善情况及手术绝对成功率\〖OR 0.39,95%CI(0.12~1.30)\〗无明显差别; 超声乳化白内障摘除联合小梁切除术并发症较多。

    结论:超声乳化白内障摘除联合房角粘连分离术或联合小梁切除术均可有效控制眼压,改善患者视力,手术效果相当。超声乳化白内障摘除联合房角粘连分离术因其并发症较少,可成为治疗闭角型青光眼合并白内障的主要治疗手段之一。

    Abstract:

    AIM:To evaluate the comparative effectiveness between phacoemulsification cataract extraction combined with either goniosynechialysis or trabeculectomy for the treatment of primary angle-closure glaucoma with cataract.

    METHODS: We searched literatures about randomized controlled trial(RCT)in phacoemulsification cataract extraction combined with goniosynechialysis compare with phacoemulsification cataract extraction combined with trabeculectomy for treatment of primary angle-closure glaucoma, in database of PubMed, Science Direct, CNKI, CqVip and Wanf, collected from January 2000 to February 2015, published or embodied. Clinical evaluation included amplitude of intraocular pressure(IOP)variation, vision improvement, anterior chamber depth change, angle open degree, success rate and postoperative complications. Revman5.0 Meta analysis software was used.

    RESULTS: According to the literature and exclusion criteria, finally 5 references were included in the Meta analysis, with a total of 492 patients. Meta analysis results showed that reduction of IOP in phacoemulsification cataract extraction combined with trabeculectomy was larger \; with goniosynechialysis, angle open degree was better, as well as the anterior chamber depth \; in vision improvement and success rate, there was no significant difference \〖OR 0.39, 95% CI(0.12~1.30)\〗; with trabeculectomy, there existed more complications.

    CONCLUSION: Phacoemulsification cataract extraction combined with either goniosynechialysis or trabeculectomy can effectively control intraocular pressure and improve visual acuity. With goniosynechialysis, because of its fewer complications, it has the potential to be one of the main treatments in treating primary angle-closure glaucoma with cataract.

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谢怡,黄丽娜.闭角型青光眼合并白内障两种手术方式比较的Meta分析.国际眼科杂志, 2015,15(9):1556-1559.

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  • 收稿日期:2015-05-22
  • 最后修改日期:2015-08-12
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  • 在线发布日期: 2015-08-27
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