Alasbali Tariq
Department of Ophthalmology, College of Medicine, Imam Mohammed IBN Saud Islamic University, Riyadh, Saudi Arabia.
Oman J Ophthalmol. 2023 Jun 27;16(2):211-219. doi: 10.4103/ojo.ojo_106_22. eCollection 2023 May-Aug.
Despite many recent developments, preference in the choice of surgical treatment of uncontrolled intraocular pressure (IOP) remains a challenge.
This study compares the clinical efficacy and safety of endoscopic cyclophotocoagulation (ECP) to alternative surgical procedures, for all types of glaucoma.
The methodology adheres to the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic review reporting. Studies reporting ECP and alternative surgeries in treating refractory glaucoma, neovascular glaucoma, aphakic glaucoma, filtering surgical failure-induced glaucoma, congenital or juvenile glaucoma, and secondary glaucoma such as uveitis glaucoma, traumatic glaucoma, secondary glaucoma postcorneal transplantation, etc. were included. The efficacy was evaluated from the number of IOP-lowering drugs, and mean change in pre- and post-IOP were the outcomes assessed in ECP and non-ECP groups in this review. Evaluations of the postoperative complications revealed the safety assessment of the procedure.
In total, 11 relevant studies were selected in this study with a total of 5418 eyes, including 763 eyes in the ECP group and 4655 in the non-ECP group. This review observed that both ECP and non-ECP procedures had been successful in reducing postoperative IOP.
It can be deduced from this review, that all types of glaucoma can be treated efficiently with significantly higher success rates with ECP and ECP demonstrates lowest postoperative complications when compared to non ECP procedures. This review provides updated scientific evidence which caters to support clinical decisions for surgical treatment of glaucoma.
尽管近年来有许多进展，但在选择治疗失控性眼压（IOP）的手术方法时仍存在挑战。
本研究比较内镜睫状体光凝术（ECP）与其他手术方法对所有类型青光眼的临床疗效和安全性。
该方法遵循系统评价和Meta分析的首选报告项目指南进行系统评价报告。纳入报告ECP和其他手术治疗难治性青光眼、新生血管性青光眼、无晶状体性青光眼、滤过性手术失败所致青光眼、先天性或青少年性青光眼以及葡萄膜炎性青光眼、外伤性青光眼、角膜移植术后继发性青光眼等继发性青光眼的研究。本综述通过降低眼压药物的数量评估疗效，评估ECP组和非ECP组术前和术后眼压的平均变化。术后并发症的评估揭示了该手术的安全性评估。
本研究共纳入11项相关研究，共5418只眼，其中ECP组763只眼，非ECP组4655只眼。本综述观察到，ECP和非ECP手术均成功降低了术后眼压。
从本综述可以推断，所有类型的青光眼都可以通过ECP得到有效治疗，成功率显著更高，并且与非ECP手术相比，ECP术后并发症最低。本综述提供了最新的科学证据，以支持青光眼手术治疗的临床决策。
