雷珠单抗玻璃体腔注射联合复合式小梁切除术及PRP治疗NVG有效性的Meta分析  

Meta-analysis of the efficacy of intravitreal Ranibizumab combined with compound trabeculectomy and panretinal photocoagulation in the treatment of neovascular glaucoma

作　　者：赵小兰 朱洪宇 代燕妮 杨小丽[1] Xiao-Lan Zhao;Hong-Yu Zhu;Yan-Ni Dai;Xiao-Li Yang(Department of Ophthalmology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China;The First Affiliated Hospital of Harbin Medical University,Harbin 150000,Heilongjiang Province,China)

机构地区：[1]川北医学院附属医院眼科,四川省南充市637000 [2]哈尔滨医科大学第一附属医院,黑龙江省哈尔滨市150000

出　　处：《国际眼科杂志》2023年第4期624-629,共6页International Eye Science

摘　　要：目的:系统评价雷珠单抗玻璃体腔注射联合复合式小梁切除及视网膜光凝术(PRP)与复合式小梁切除术联合PRP治疗新生血管性青光眼(NVG)的有效性和安全性。方法:检索万方数据库、中国知网(CNKI)、PubMed、EMbase、中国生物医学文献服务系统(CBM)、Clinicalkey、Cochrane Library数据库,查找自建库至2022-07-20试验组为雷珠单抗玻璃体腔注射联合复合式小梁切除术及PRP治疗NVG,对照组为复合式小梁切除术联合PRP治疗NVG的临床研究,同时查阅相关参考文献。提取最佳矫正视力、眼压、并发症发生情况、手术成功率进行分析。结果:本研究共纳入8篇临床研究,NVG患者864例864眼。Meta分析结果提示,试验组患者术后1wk,1、3mo时眼压较对照组下降更低(术后1wk:MD=-4.00,95%CI:-4.62~-3.38,P<0.05;术后1mo:MD=-4.11,95%CI:-4.66~-3.56,P<0.05;术后3mo:MD=-4.58,95%CI:-5.61~-3.55,P<0.05);试验组患者术后1mo时最佳矫正视力优于对照组(MD=0.17,95%CI:0.11~0.23,P<0.05),但两组患者术后1wk时无差异(MD=0.08,95%CI:-0.13~0.29,P=0.47);试验组患者术后并发症发生更少(OR=0.30,95%CI:0.18~0.52,P<0.05),手术成功率更高(OR=5.15,95%CI:2.78~9.53,P<0.05)。结论:雷珠单抗玻璃体腔注射联合复合式小梁切除术及PRP治疗NVG可降低眼压、改善视力,手术成功率优于复合式小梁切除术联合PRP。AIM:To systematically evaluate the efficacy and safety of intravitreal ranibizumab combined with compound trabeculectomy and panretinal photocoagulation(PRP)compared with compound trabeculectomy combined with PRP in the treatment of neovascular glaucoma(NVG).METHODS:Databases including Wanfang database,China National Knowledge Infrastructure(CNKI),PubMed,EMbase,China Biomedical Document Service System(CBM),Clinicalkey,and Cochrane Library were retrieved.Literatures about intravitreal ranibizumab combined with compound trabeculectomy and PRP in the treatment of NVG in the experimental group and compound trabeculectomy and PRP in the treatment of NVG in the control group from creation of database to July 20,2022 were searched.At the same time,relevant reference were consulted.The best corrected visual acuity,intraocular pressure,occurrence of complications and the success rate of the surgery were systematically evaluated.RESULTS:A total of 8 clinical studies were included,with 864 patients(864 eyes)with NVG.Meta-analysis showed that the intraocular pressure of patients in the experimental group was lower than that in the control group at 1wk,1 and 3mo after surgery(1wk:MD=-4.00,95%CI:-4.62~-3.38,P<0.05;1mo:MD=-4.11,95%CI:-4.66~-3.56,P<0.05;3mo:MD=-4.58,95%CI:-5.61~-3.55,P<0.05).The best corrected visual acuity of the experimental group was better than that of the control group at 1mo after surgery(MD=0.17,95%CI:0.11~0.23,P<0.05),but there was no significant difference at 1wk after surgery(MD=0.08,95%CI:-0.13~0.29,P=0.47).The patients in the experimental group had fewer complications(OR=0.30,95%CI:0.18~0.52,P<0.05)and higher surgical success rate(OR=5.15,95%CI:2.78~9.53,P<0.05).CONCLUSION:With decreased intraocular pressure,improved visual acuity and surgical success rate,intravitreal ranibizumab combined with compound trabeculectomy and PRP was better than the compound trabeculectomy and PRP in the treatment of NVG.

关 键 词：雷珠单抗 复合式小梁切除术 视网膜光凝术 术后眼压 最佳矫正视力 并发症 

分 类 号：R779.6[医药卫生—眼科]