两种不同方法植入引流阀治疗青光眼的Meta分析  

Comparison of efficacy and safety of posterior chamber glaucoma drainage device implantation with anterior chamber drainage device implantation for treatment of glaucoma:a meta-analysis

作　　者：王斌[1] 李文伟[1] 王凯军[2] WANG Bin;LI Wenwei;WANG Kaijun(Department of Ophthalmology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院眼科,杭州310012 [2]浙江大学附属第二医院眼科中心

出　　处：《浙江医学》2020年第11期1138-1142,共5页Zhejiang Medical Journal

基　　金：浙江省自然科学基金社会发展项目(LY19H120006)。

摘　　要：目的评价后房与前房植入引流阀两种方法治疗青光眼的有效性及安全性。方法计算机检索PubMed、EMBASE、Cochrane Library数据库并收集所有与后房、前房植入引流阀治疗青光眼相关的临床对照试验。有效性评价包括以加权平均数(WMD)作为测量指标的眼压差值、青光眼药物减少量。安全性评价包括以比值比(OR)作为测量指标的角膜失代偿率、总并发症发生率。结果最终纳入文献4篇,共275眼,后房组135眼,前房组140眼。Meta分析结果显示,两组眼压差值(WMD=-1.01mmHg,95%CI:-4.05~2.03,P>0.05)、青光眼药物减少值(WMD=0.23,95%CI:-0.11~0.56,P>0.05)、角膜失代偿率(WMD=1.01,95%CI:0.03~40.76,P>0.05)及并发症发生率(WMD=1.19,95%CI:0.68~2.09,P>0.05)差异均无统计学意义。结论后房与前房植入引流阀治疗青光眼有相似的疗效和安全性,但尚需高质量的前瞻性研究结果进一步证实。Objective To compare the efficacy and safety of posterior chamber glaucoma drainage device(PC GDD)with anterior chamber glaucoma drainage device(AC GDD)for the treatment of glaucoma.Methods According to evaluation guidelines of Cochrane collaboration,clinical controlled studies were searched through PubMed,EMBASE,and the Cochrane Library databases.The continuous variables,namely,intraocular pressure(IOP)and glaucoma medications,were pooled by the weighted mean differences(WMD),and the dichotomous outcomes,including corneal failure incidence and overall complications incidence,were pooled by the odds ratio(OR).Results Four studies involving 275 eyes were included for analysis,including 135 eyes in the PC GDD group and 140 eyes in the AC GDD group.The WMD of the IOP reduction between the PC GDD group and the AC GDD group were-1.01mmHg(95%CI:-4.05-2.03,P>0.05).The WMD of the glaucoma medications reduction between the PC GDD group and the AC GDD group were 0.23(95%CI:-0.11-0.56,P>0.05).The pooled OR comparing PP GDD group with AC GDD group were 1.01(95%CI:0.03-40.76,P>0.05)for corneal failure incidence and 1.19(95%CI:0.68-2.09,P>0.05)for overall complication incidence.There were no significant differences between PC GDD group and AC GDD group in these indicators.Conclusion PC GDD and AC GDD procedures have similar efficacy of reduction in the IOP and number of medications.They are also comparable on the safety with similar incidence of corneal failure and overall complications.

关 键 词：青光眼 引流阀 后房 前房 META分析 

分 类 号：R779.6[医药卫生—眼科]