Shen Tian-Yi, Hu Wei-Nan, Cai Wen-Ting, Jin Hui-Zi, Yu Dong-Hui, Sun Jing-Hui, Yu Jing
Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China.
Ninghai First Hospital, Ninghai, Zhejiang 315600, China.
J Ophthalmol. 2020 Oct 9;2020:3949735. doi: 10.1155/2020/3949735. eCollection 2020.
To determine the effectiveness and safety of trabeculectomy along with amniotic membrane transplantation (AMT) for glaucoma.
This systematic review was performed using RevMan 5.3. We searched PubMed, EMBASE, and the Cochrane Library and included studies published until September 2019. The treatment group included patients with AMT and trabeculectomy (group A), and the control group had only trabeculectomy (group B). We only included randomized controlled trials. The outcomes were intraocular pressure (IOP), complete success rate, number of antiglaucoma medications, and complications.
Five studies, including 174 eyes (87 eyes in the AMT group and 87 eyes in the control group), were eligible in this review. The parameters had no significant difference in heterogeneity between the AMT and control groups preoperatively. In the AMT group, the mean IOP was significantly lower at 3 and 12 months after operation ( < 0.0001 and = 0.02, respectively), while the number of complete successes in the AMT group was significantly higher at 6 and 12 months ( = 0.02 and = 0.003, respectively) compared with the control group. Complications, including a flat anterior chamber and hyphema, appeared to be decreased in the AMT group compared to the control group ( = 0.02 and = 0.02, respectively). No differences were observed in the number of antiglaucoma medications, hypotony, encapsulated bleb, or choroidal detachment.
Compared with only trabeculectomy, it is more efficient and safer to add AMT to trabeculectomy during glaucoma filtering surgery.
确定小梁切除术联合羊膜移植术（AMT）治疗青光眼的有效性和安全性。
使用RevMan 5.3进行该系统评价。检索了PubMed、EMBASE和Cochrane图书馆，并纳入截至2019年9月发表的研究。治疗组包括接受AMT和小梁切除术的患者（A组），对照组仅接受小梁切除术（B组）。仅纳入随机对照试验。观察指标为眼压（IOP）、完全成功率、抗青光眼药物数量及并发症。
本评价纳入5项研究，共174只眼（AMT组87只眼，对照组87只眼）。术前AMT组和对照组各项参数在异质性方面无显著差异。在AMT组，术后3个月和12个月时平均眼压显著更低（分别为<0.0001和=0.02），而与对照组相比，AMT组在6个月和12个月时完全成功的数量显著更高（分别为=0.02和=0.003）。与对照组相比，AMT组并发症（包括浅前房和前房积血）似乎减少（分别为=0.02和=0.02）。在抗青光眼药物数量、低眼压、包裹性滤过泡或脉络膜脱离方面未观察到差异。
与单纯小梁切除术相比，青光眼滤过手术中在小梁切除术中加用AMT更有效且更安全。
