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非穿透性滤过性手术与小梁切除术治疗术后散光的比较：荟萃分析。

Non-penetrating filtration surgery versus trabeculectomy in postoperative astigmatism: a meta-analysis.

机构信息

Aier Eye Hospital, Jinan University, Guangzhou, Guangdong Province, China.

Changsha Aier Eye Hospital, No.188 South Furong Road, Changsha, Hunan, 410015, China.

出版信息

BMC Ophthalmol. 2024 Aug 28;24(1):381. doi: 10.1186/s12886-024-03651-y.

DOI:10.1186/s12886-024-03651-y
PMID:39198787
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11351589/
Abstract

OBJECTIVE

Trabeculectomy and non-penetrating trabecular surgery are common operations for glaucoma. This meta-analysis aims to compare the effect of trabeculectomy and non-penetrating trabecular surgery in postoperative astigmatism of patients with glaucoma.

METHODS

A systematic literature search was performed for studies comparing trabeculectomy and non-penetrating trabecular surgery in patients with glaucoma. The time frame for the search was from the time of construction to April 2024. There were no restrictions regarding study type or type of glaucoma. The endpoint was the surgically induced astigmatism assessed 6 months after operation. We conducted this meta-analysis following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis).

RESULTS

Five eligible studies were included in this meta-analysis and presented data for 359 eyes with various types of glaucoma at different stages. The results revealed an increase in astigmatism in patients with glaucoma after trabeculectomy and non-penetrating trabecular surgery. Trabeculectomy had a higher incidence of astigmatism than in the non-penetrating trabecular surgery group at or around 6 months postoperatively, and the difference was statistically significant. (SMD = 0.40, 95% CI = 0.19 to 0.61, P = 0.02).

CONCLUSION

Our results demonstrated that both trabeculectomy and non-penetrating trabecular surgery could increase astigmatism until 6 months after operation. Moreover, non-penetrating trabecular surgery group seems to have less influence on astigmatism.

TRIAL REGISTRATION NUMBER

CRD42024517708.

摘要

目的

小梁切除术和非穿透性小梁手术是治疗青光眼的常见手术。本荟萃分析旨在比较青光眼患者小梁切除术和非穿透性小梁手术对术后散光的影响。

方法

对比较青光眼患者小梁切除术和非穿透性小梁手术的研究进行系统文献检索。检索时间范围为从建立时间到 2024 年 4 月。研究类型和青光眼类型均不受限制。终点是术后 6 个月评估的手术诱导散光。我们按照 PRISMA（系统评价和荟萃分析的首选报告项目）进行了这项荟萃分析。

结果

本荟萃分析纳入了 5 项符合条件的研究，这些研究提供了不同阶段、不同类型青光眼的 359 只眼的数据。结果表明，青光眼患者小梁切除术和非穿透性小梁手术后散光增加。小梁切除术在术后 6 个月或接近 6 个月时的散光发生率高于非穿透性小梁手术组，差异具有统计学意义。（SMD=0.40，95%CI=0.19 至 0.61，P=0.02）。

结论

我们的结果表明，小梁切除术和非穿透性小梁手术均可导致术后 6 个月内散光增加。此外，非穿透性小梁手术组对散光的影响似乎较小。

试验注册号

CRD42024517708。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/253c0845c3e0/12886_2024_3651_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/422d8541d343/12886_2024_3651_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/6809b29caaee/12886_2024_3651_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/dc2f4a1c4557/12886_2024_3651_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/253c0845c3e0/12886_2024_3651_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/422d8541d343/12886_2024_3651_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/6809b29caaee/12886_2024_3651_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/dc2f4a1c4557/12886_2024_3651_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4756/11351589/253c0845c3e0/12886_2024_3651_Fig4_HTML.jpg

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本文引用的文献

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CO laser-assisted sclerectomy surgery compared with trabeculectomy in primary open-angle glaucoma and exfoliative glaucoma. A 1-year follow-up.CO2 激光辅助巩膜切除术与小梁切除术治疗原发性开角型青光眼和剥脱性青光眼的比较。1 年随访。
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Eye Vis (Lond). 2017 Nov 17;4:27. doi: 10.1186/s40662-017-0090-x. eCollection 2017.
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[Comparison of trabeculectomy and canaloplasty : Pressure reducing effect and postoperative interventions/complications].
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Nonpenetrating glaucoma surgery.非穿透性青光眼手术
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