原发性闭角型青光眼合并白内障手术方式的系统评价  

Systematic review of surgical treatment for primary angle-closure glaucoma accompanied with Cataract

作　　者：时少丹 刘景[2] 张伟[2] 张晗[2] 

机构地区：[1]沧州市人民医院眼科,河北沧州061000 [2]山东大学第二医院眼科,济南250033

出　　处：《山东大学耳鼻喉眼学报》2013年第5期84-90,共7页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的对原发性闭角型青光眼合并白内障手术方式进行循证医学系统评价，为手术方式选择提供循证医学证据。方法按照循证医学系统评价要求，检索PubMed、EMBASE、CochraneLibrary及CNKI和CBM发表的相关中、英文文献（2005．01～2011．07）。观察指标包括治疗前后视力、眼压、眼压控制成功率、视野损害进展、RNFL、房角粘连变化、并发症等。结果共10篇英文和13篇中文文献入选。其中Ⅰ-Ⅱ级证据11篇，Ⅲ级证据7篇，Ⅳ级证据5篇，涉及手术方式包括：LPI、SPI、ECCE、Phaco、Phaco—GSL、Phaco＋SPI、PhacoTrab＋IOL及小梁切除术。结论循证医学系统评价证实超乳手术可作为PACG合并白内障手术方式。手术适应证方面临床需要进一步大样本、多中心RCT研究，建议研究中纳入有关视神经损害及长期降眼压效果的观察指标。Objective To make an evidence-based assessment oo the surgical treatment for primary angle-closure glau- coma accompanied with cataract. Methods According to the evidence-based principles, studies published in the Eng- lish language in PubMed, EMBASE, and Cochrane Library, as well as those in the Chinese language in journals of Chi- nese Periodical Fulltext Database and Chinese Bio-medicine Database, from Jan. 2005 to Jul. 2011, were searched and selected. Outcome measures consisted of visual acuity, intraocular pressure（ IOP）, success rate of controlling lOP, pro- gression in visual field loss, Thickness of retinal nerve fiber layer （ RNFL）, goniosynechia, UBM, complications, et al. Results Ten articles in English and thirteen articles in Chinese were eligible, in which eleven were in grade Ⅰ - Ⅱ, seven were in grade Ⅲ, and five were in grade Ⅳ. The interventions included LPI, SPI, ECCE, Phaco, Phaco-GSL, Phaco ＋ SPI, PhacoTrab ＋ IOL and trabeculectomy. Conclusion Evidence-based medicine assessment suggested that phacoemulsification could be the good choice in the surgical treatment for PACG accompanied with cataract. Random- ized controlled trials of large samples and multi-center study are needed. Meanwhile, damage of optic nerve and long- term follow-up on postoperative intraocular pressure should be investigated in the further research.

关 键 词：青光眼 白内障 治疗 系统综述 

分 类 号：R775.2[医药卫生—眼科]