Mahdavi Fard Ali, Patel Sangita P, Pourafkari Leili, Nader Nader D
Department of Ophthalmology, University at Buffalo, Buffalo, NY, USA Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Ophthalmology, Ross Eye Institute, The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA Ophthalmology and Research Service, Veterans Administration Western New York Healthcare, System, Buffalo, NY, USA SUNY Eye Institute, Buffalo, NY, USA.
Ther Adv Chronic Dis. 2019 Jan 31;10:2040622318820850. doi: 10.1177/2040622318820850. eCollection 2019.
The aim of this study was to conduct a meta-analysis to compare the overall intraocular pressure (IOP)-lowering effect of iStent or CyPass as isolated procedures or in combination with cataract extraction.
Cochrane review manager 5.3 software (RevMan 5.3) was used for a meta-analysis of IOPs and the number of antiglaucoma medications in six groups according to the type and number of stents and whether the procedure was isolated or in combination with cataract extraction.
A total of 33 out of 446 publications retrieved have been enrolled. The mean changes in IOP in the groups with one iStent and more than two iStents with concurrent cataract extraction were -3.78 ± 0.53 mmHg and -3.89 ± 0.73 mmHg, respectively. The mean differences in IOP in the groups with one iStent and more than two iStents without concurrent cataract extraction were -3.96 ± 0.25 mmHg and -7.48 ± 0.55 mmHg, respectively. The mean changes in IOP in the groups with CyPass implantation with and without concurrent cataract extraction were -4.97 ± 1.38 mmHg and -8.96 ± 0.16 mmHg, respectively.
Both iStent and CyPass either in combination with cataract extraction or as isolated procedures effectively decrease IOP. This effect is greatest with isolated implantation of CyPass followed by multiple iStents and then single iStent implantation and lasts up to 2 years.
本研究的目的是进行一项荟萃分析，以比较iStent或CyPass单独使用或与白内障摘除术联合使用时降低眼内压（IOP）的总体效果。
使用Cochrane综述管理器5.3软件（RevMan 5.3）对六组患者的眼内压和抗青光眼药物数量进行荟萃分析，这六组根据支架的类型和数量以及手术是单独进行还是与白内障摘除术联合进行来划分。
在检索到的446篇出版物中，共有33篇被纳入。在同时进行白内障摘除术的单枚iStent组和两枚以上iStent组中，眼内压的平均变化分别为-3.78±0.53mmHg和-3.89±0.73mmHg。在未同时进行白内障摘除术的单枚iStent组和两枚以上iStent组中，眼内压的平均差异分别为-3.96±0.25mmHg和-7.48±0.55mmHg。在植入CyPass且同时进行和未同时进行白内障摘除术的组中，眼内压的平均变化分别为-4.97±1.38mmHg和-8.96±0.16mmHg。
iStent和CyPass无论是与白内障摘除术联合使用还是单独使用，均能有效降低眼内压。单独植入CyPass的效果最佳，其次是多枚iStent，然后是单枚iStent植入，且这种效果可持续长达2年。
