非穿透性青光眼手术治疗开角型青光眼有效性的系统评价

发布时间：2019-05-14 23:14

【摘要】：目的评估非穿透性青光眼手术(NPGS)治疗开角型青光眼患者的降眼压(IOP)效果。方法全面收集评价NPGS治疗原发性/继发性开角型青光眼的随机对照试验,进行系统评价。主要疗效指标包括IOP下降百分比和IOP达标率。应用多功能meta分析软件2.0版的随机效应模型进行汇总分析,计算合并评价量。结果术后2年,与小梁切除术(TE)相比,深层巩膜切开术(DS)、黏小管切开术(VCO)的降眼压作用均相对较低,IOP下降百分比分别为35.2%(DS)、30.2%(VCO)、45.6%(TE)。术中加用植入物及丝裂霉素C(MMC)均可提高DS的降眼压作用,术后2年的IOP下降百分比分别为41.1%和41.7%。术后4年,DS、VCO、TE的IOP达标率分别为35.4%、22.7%、47.6%;DS加用植入物和MMC的IOP达标率分别为64.6%、52.1%,高于单纯DS。NPGS并发症的发生率较TE低。结论常用的NPGS(DS和VCO)能有效降低眼压,并发症也比TE少,但是NPGS的降眼压作用要比TE为低。术中加用植入物、MMC可提高DS的降眼压作用。
[Abstract]:Objective to evaluate the (IOP) effect of non-penetrating glaucoma surgery (NPGS) in the treatment of open-angle glaucoma. Methods A randomized controlled trial was conducted to evaluate NPGS in the treatment of primary / secondary open-angle glaucoma. The main curative effect indexes included the percentage decrease of IOP and the rate of IOP reaching the standard. The random effect model of multifunctional meta analysis software version 2.0 is used to summarize and analyze, and the combined evaluation quantity is calculated. Results 2 years after operation, compared with (TE), deep scleral incision (VCO) had a relatively low intraocular pressure reduction effect, and the percentage of IOP decreased by 35.2% (DS), 30.2% (VCO), respectively. 45.6 per cent (TE). The intraocular pressure reduction effect of DS was increased by adding implantation and mitomycin C (MMC) during operation. The percentage of IOP decreased by 41.1% and 41.7% respectively 2 years after operation. Four years after operation, the IOP compliance rate of DS,VCO,TE was 35.4%, 22.7%, 47.6% of DS plus implantation and MMC were 64.6% and 52.1%, respectively. The incidence of complications of DS.NPGS was lower than that of TE. Conclusion the commonly used NPGS (DS and VCO can effectively reduce intraocular pressure (IOP), and the complications are less than TE, but the IOP lowering effect of NPGS is lower than that of TE. MMC can improve the intraocular pressure reduction effect of DS by adding implantable materials during operation.
【作者单位】：第二军医大学长征医院眼科;南京军区总医院眼科;
【基金】：国家自然科学基金(81000374,81170874) 上海市自然科学基金(10ZR1439300) 上海市青年科技启明星计划(12QA1404600)~~
【分类号】：R779.6

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