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青光眼手术治疗中黑人和白人人群的预后差异

Outcomes Disparities between Black and White Populations in the Surgical Management of Glaucoma.

作者信息

Taubenslag Kenneth J, Kammer Jeffrey A

机构信息

a Vanderbilt Eye Institute , Vanderbilt University School of Medicine , Nashville , TN , USA.

出版信息

Semin Ophthalmol. 2016;31(4):385-93. doi: 10.3109/08820538.2016.1154163. Epub 2016 Jul 1.

Abstract

African descent is a well-documented risk factor for glaucoma development, progression, and medical and surgical failure. We reviewed the literature for evidence of outcomes disparities between Black and White populations after trabeculectomy, Ex-PRESS shunt, viscocanalostomy, canaloplasy, tube shunt, laser trabeculoplasty, and cyclophotocoagulation. There are reports of decreased surgical success in Black patients after trabeculectomy, Ex-PRESS shunt, tube-shunt, and canaloplasty. At this time, there is no strong evidence that any procedure is more effective for intraocular pressure control than standard trabeculectomy for Black patients. Furthermore, there is insufficient evidence to recommend any particular secondary intervention over another, despite differences in inflammation and bleb-dependence. There is a need for randomized, controlled trials to assess race as a risk factor for failure after non-penetrating filtration surgery (NPFS). There is also a need for data on the efficacy of minimally invasive glaucoma surgery (MIGS) in Black populations.

摘要

非洲裔是青光眼发生、进展以及药物和手术治疗失败的一个有充分文献记载的风险因素。我们查阅了文献,以寻找有关小梁切除术、Ex-PRESS分流术、粘小管成形术、睫状体光凝术、引流管分流术、激光小梁成形术和睫状体光凝术后黑人和白人患者结局差异的证据。有报道称,黑人患者在接受小梁切除术、Ex-PRESS分流术、引流管分流术和睫状体成形术后手术成功率降低。目前,没有强有力的证据表明,对于黑人患者,任何一种手术在控制眼压方面比标准小梁切除术更有效。此外,尽管在炎症和滤泡依赖性方面存在差异,但没有足够的证据推荐某种特定的二次干预措施优于另一种。需要进行随机对照试验,以评估种族作为非穿透性滤过手术(NPFS)后失败的风险因素。还需要有关微创青光眼手术(MIGS)在黑人人群中疗效的数据。

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