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开角型青光眼患者激光治疗的有效性:一项系统评价和荟萃分析研究。

Effectiveness of laser therapy among patients with open-angle glaucoma: a systematic review and meta-analysis study.

作者信息

Safarpour Lima Behzad, Sayanjali Shima

机构信息

Clarity Eye Institute, Vaughan, ON.

出版信息

Eur J Transl Myol. 2024 Oct 22;34(4):12931. doi: 10.4081/ejtm.2024.12931.

DOI:10.4081/ejtm.2024.12931
PMID:39440584
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11726179/
Abstract

This study aims to evaluate the efficacy of selective laser trabeculoplasty in improving the intraocular pressure in patients diagnosed with open-angle glaucoma. A comprehensive search was performed across electronic databases, including PubMed, Scopus, and Web of Science, until June 2024, using keywords related to "selective laser trabeculoplasty" and "open-angle glaucoma." Studies were chosen based on set eligibility criteria. Data extraction was carried out by two independent reviewers, and statistical analyses were performed using a random-effects model to calculate the pooled mean differences in IOP reduction and overall success rates. The initial search yielded 3111 articles, with 23 studies included in the systematic review and 22 in the meta-analysis. The pooled MD in IOP reduction between the SLT and control groups was -1.44 mm Hg (95% CI: -2.19 to -0.70, p < 0.01). Subgroup analyses revealed a MD of -0.76 mm Hg (95% CI: -1.31 to -0.21, p < 0.01) when comparing SLT to medication, and -0.42 mm Hg (95% CI: -0.64 to -0.19, p < 0.01) when comparing 180-degree SLT to 360-degree SLT. The pooled success rate favored SLT with an odds ratio (OR) of 0.71 (95% CI: 0.51 to 0.99, p = 0.05). There was significant heterogeneity among the studies (I² = 71%). SLT is effective in lowering IOP in OAG patients, demonstrating significant efficacy compared to medication and different SLT protocols. The findings underscore SLT's potential as a reliable treatment option. However, the observed heterogeneity underscores the necessity for standardized protocols in future research to improve comparability and verify SLT's long-term effectiveness.

摘要

本研究旨在评估选择性激光小梁成形术在改善开角型青光眼患者眼压方面的疗效。截至2024年6月,在包括PubMed、Scopus和Web of Science在内的电子数据库中进行了全面检索,使用了与“选择性激光小梁成形术”和“开角型青光眼”相关的关键词。根据设定的纳入标准选择研究。由两名独立的评审员进行数据提取,并使用随机效应模型进行统计分析,以计算眼压降低的合并平均差异和总体成功率。初步检索得到3111篇文章,其中23项研究纳入系统评价,22项纳入荟萃分析。选择性激光小梁成形术(SLT)组与对照组眼压降低的合并平均差为-1.44 mmHg(95%CI:-2.19至-0.70,p<0.01)。亚组分析显示,SLT与药物治疗相比,平均差为-0.76 mmHg(95%CI:-1.31至-0.21,p<0.01);180度SLT与360度SLT相比,平均差为-0.42 mmHg(95%CI:-0.64至-0.19,p<0.01)。合并成功率支持SLT,优势比(OR)为0.71(95%CI:0.51至0.99,p=0.05)。研究之间存在显著异质性(I²=71%)。SLT在降低开角型青光眼患者眼压方面有效,与药物治疗和不同的SLT方案相比显示出显著疗效。研究结果强调了SLT作为一种可靠治疗选择的潜力。然而,观察到的异质性强调了未来研究中采用标准化方案以提高可比性并验证SLT长期有效性的必要性。

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本文引用的文献

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180- Versus 360-Degree Selective Laser Trabeculoplasty in Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-Analysis.180 度与 360 度选择性激光小梁成形术治疗开角型青光眼和高眼压症:系统评价和荟萃分析。
J Glaucoma. 2024 Aug 1;33(8):566-575. doi: 10.1097/IJG.0000000000002415. Epub 2024 May 6.
2
Selective laser trabeculoplasty in the treatment of juvenile open angle glaucoma patients under 25 years of age.选择性激光小梁成形术治疗 25 岁以下青少年开角型青光眼。
Int Ophthalmol. 2024 Apr 26;44(1):201. doi: 10.1007/s10792-024-03108-7.
3
Identifying Baseline Predictors of Selective Laser Trabeculoplasty Effectiveness: An Alternative Mathematical Approach.
确定选择性激光小梁成形术有效性的基线预测因素:一种替代数学方法。
Cureus. 2024 Feb 13;16(2):e54116. doi: 10.7759/cureus.54116. eCollection 2024 Feb.
4
Intraocular pressure profile following selective laser trabeculoplasty in pigmentary and primary open-angle glaucoma.色素性青光眼和原发性开角型青光眼行选择性激光小梁成形术后的眼压曲线。
Eur J Ophthalmol. 2024 Nov;34(6):1957-1963. doi: 10.1177/11206721241237305. Epub 2024 Mar 12.
5
Selective laser trabeculoplasty: An updated narrative review.选择性激光小梁成形术:更新的叙述性综述。
Indian J Ophthalmol. 2024 Mar 1;72(3):312-319. doi: 10.4103/IJO.IJO_2104_23. Epub 2024 Feb 28.
6
An Exploratory Retrospective Data Analysis Comparing the Outcomes of Selective Laser Trabeculoplasty and Argon Laser Trabeculoplasty in Patients with Open-Angle Glaucoma or Ocular Hypertension in Vienna, Austria, from the Year 2012 to 2022.一项探索性回顾性数据分析,比较了 2012 年至 2022 年在奥地利维也纳的开角型青光眼或高眼压症患者中选择性激光小梁成形术和氩激光小梁成形术的疗效。
Medicina (Kaunas). 2023 Nov 24;59(12):2075. doi: 10.3390/medicina59122075.
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