Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Ophthalmology, Affiliated Nanping First Hospital of Fujian Medical University, Nanping, Fujian, China.
Transl Vis Sci Technol. 2023 Sep 1;12(9):12. doi: 10.1167/tvst.12.9.12.
The aim of this study was to compare the safety and efficacy of trabeculectomy alone or combined with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents for the treatment of neovascular glaucoma.
We conducted a systematic review and meta-analysis to compare the effects of trabeculectomy alone or combined with intravitreal injections of anti-VEGF agents for the treatment of neovascular glaucoma. We searched four databases (PubMed, Cochrane Library, Embase, and Web of Science) up to January 2023 and extracted data on three surgical outcomes: postoperative intraocular pressure, success rate and complications. We used a random-effects model to calculate pooled relative risk (RR) or standardized mean difference (SMD) estimates and 95% confidence intervals (CIs). We assessed publication bias using Begg and Egger tests.
We included seven studies with 353 eyes. Compared to trabeculectomy alone, trabeculectomy with anti-VEGF had a lower risk of postoperative complications (RR, 0.60; 95% CI, 0.41-0.89) and higher success rate (RR, 1.19; 95% CI, 1.02-1.40). The intraocular pressure reduction was significantly greater in the trabeculectomy with anti-VEGF augmentation group than the trabeculectomy group from 1 week (SMD, -1.36; 95% CI, -2.76 to 0.04) to 6 months (SMD, -0.79; 95% CI, -1.50 to -0.07) after surgery.
According to current evidence, adding intravitreal injection of anti-VEGF agents to trabeculectomy may improve the short time outcomes of patients with neovascular glaucoma.
本研究旨在比较单纯小梁切除术与联合玻璃体内注射抗血管内皮生长因子（anti-VEGF）药物治疗新生血管性青光眼的安全性和疗效。
我们进行了系统评价和荟萃分析，比较了单纯小梁切除术与联合玻璃体内注射抗 VEGF 药物治疗新生血管性青光眼的疗效。我们检索了四个数据库（PubMed、Cochrane 图书馆、Embase 和 Web of Science），截至 2023 年 1 月，提取了三种手术结果的数据：术后眼压、成功率和并发症。我们使用随机效应模型计算汇总相对风险（RR）或标准化均数差（SMD）估计值和 95%置信区间（CI）。我们使用 Begg 和 Egger 检验评估发表偏倚。
我们纳入了 7 项研究共 353 只眼。与单纯小梁切除术相比，小梁切除术联合抗 VEGF 治疗的术后并发症风险较低（RR，0.60；95%CI，0.41-0.89），成功率较高（RR，1.19；95%CI，1.02-1.40）。小梁切除术联合抗 VEGF 强化治疗组的眼压降低幅度从术后 1 周（SMD，-1.36；95%CI，-2.76 至 0.04）到 6 个月（SMD，-0.79；95%CI，-1.50 至-0.07）均显著大于单纯小梁切除术组。
根据现有证据，小梁切除术联合玻璃体内注射抗 VEGF 药物可能改善新生血管性青光眼患者的短期疗效。
