摘要
目的 评价首选青光眼引流装置（GDD）植入术与小梁切除术治疗青光眼的疗效及术后并发症的差异.设计系统综述.研究对象国内外于1966年至2009年发表与未发表的以青光眼患者作为研究对象,治疗方案采用GDD植入术与小梁切除术相比较的所有临床对照研究.方法 采用Cochrane系统评价方法,检索Medline（1966～2009）、Embase（1966～2009）、Cochrane图书馆（2009）及中国生物医学文献数据库CBM（1979～2009）,按照纳入和排除标准收集所有相关临床对照研究,通过Jadad评分量表进行文献质量评估后,使用Cochrare协作网提供的RevMan4.2统计软件进行Meta分析,以获得GDD植入术与小梁切除术治疗青光眼患者的疗效及术后并发症是否存在差异的相关证据.主要指标不同研究中眼压降低、最佳矫正视力和术后并发症发生的组间差异.结果 共纳入GDD植入术与小梁切除术治疗青光眼的临床对照研究8项,共计877眼.Meta分析结果显示,GDD植入术治疗青光眼在降低眼压、维持最佳矫正视力方面,与联合抗代谢药物的小梁切除术治疗组间的差异没有统计学意义（P〉0.05）.各研究中随访期间两组间并发症和不良事件的发生分别为20.2%（GDD植入术组）和22.1%（小梁切除术组）,两组间差异无统计学意义（P〉0.05）.结论 首选GDD植入术治疗青光眼与小梁切除术相比疗效相仿、术后并发症发生率近似,两术式间在疗效和安全性方面未见明显差异.
Objective To compare the efficacy and complications in treatment of glaucoma by glaucoma drainage device （GDD） implantation with trabeculectomy for first priority. Design A systematic review with meta-analysis. Participants The studies on the efficacy and complications in treatment of glaucoma by GDD implantation and trabeculectomy. Methods According to evaluation guidelines of Cochrane collaboration, clinical controlled trials （CCTs） comparing GDD implantation with trabeculectomy in treatment of glaucoma were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology qualities of literatures were performed by experienced researchers according to the Jadad Score. RevMan 4.2 offered by Cochrane was used to do the meta-analysis. Main Outcome Measures The difference of IOP lowing, the best corrected visual acuity （BCVA）, and the complications in treatment of glaucoma by GDD implantation and trabeculeetomy in different studies. Results Only 8 literatures were brought into meta-analysis （877 eyes）. The result of analysis showed that there was no significant difference between the GDD implantation and trabeculectomy for controlling the intraocular pressure and maintaining the BCVA in treatment of glaucoma （P〉0.05）. The GDD implantation did not display any statistic difference in the postoperative complications compared with trabeculectomy （P〉0.05）. Conclusion Meta-analysis shows that GDD implantation has equal efficacy and safety to trabeeulectomy with antimetabolites in treatment of glaucoma.
出处
《眼科》
CAS
2010年第6期397-402,共6页
Ophthalmology in China
