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Abstract：
To compare the efficacy and safety of tube shunt implantation with trabeculectomy in the treatment of patients with glaucoma.
A systematic literature search was performed for studies comparing tube with trabeculectomy in patients with glaucoma (final search date: 27 February 2022). Comparisons between tube and trabeculectomy were grouped by the type of tube (Ahmed, Baerveldt, Ex-PRESS and XEN). The primary endpoints included intraocular pressure (IOP), IOP reduction (IOPR), IOPR percentage (IOPR%), complete success rate (CSR), qualified success rate (QSR) and adverse events (AEs).
Forty-nine studies were included in this meta-analysis and presented data for 3795 eyes (Ahmed: 670, Baerveldt: 561, Ex-PRESS: 473, XEN: 199, trabeculectomy: 1892). Ahmed and Ex-PRESS were similar to trabeculectomy in terms of IOP outcomes and success rate (Ahmed vs trabeculectomy: IOPR%: mean difference (MD)=1.34 (-5.35, 8.02), p=0.69; Ex-PRESS vs trabeculectomy: IOPR%: MD=0.12 (-3.07, 3.31), p=0.94). The IOP outcomes for Baerveldt were worse than those for trabeculectomy (IOPR%: MD=-7.51 (-10.68, -4.35), p<0.00001), but the QSR was higher. No significant difference was shown for the CSR. XEN was worse than trabeculectomy in terms of IOP outcomes (IOPR%: MD=-7.87 (-13.55, -2.18), p=0.007), while the success rate was similar. Ahmed and Ex-PRESS had a lower incidence of AEs than trabeculectomy. Baerveldt had a lower incidence of bleb leakage/wound leakage, hyphaema and hypotonic maculopathy than trabeculectomy but a higher incidence of concurrent cataracts, diplopia/strabismus and tube erosion. The incidence of AEs was similar for the XEN and trabeculectomy procedures.
Compared with trabeculectomy, both Ahmed and Ex-PRESS appear to be associated with similar ocular hypotensive effects and lower incidences of AEs. However, Baerveldt and XEN cannot achieve sufficient reductions in IOP outcomes similar to those of trabeculectomy.
CRD42021257852.
A systematic literature search was performed for studies comparing tube with trabeculectomy in patients with glaucoma (final search date: 27 February 2022). Comparisons between tube and trabeculectomy were grouped by the type of tube (Ahmed, Baerveldt, Ex-PRESS and XEN). The primary endpoints included intraocular pressure (IOP), IOP reduction (IOPR), IOPR percentage (IOPR%), complete success rate (CSR), qualified success rate (QSR) and adverse events (AEs).
Forty-nine studies were included in this meta-analysis and presented data for 3795 eyes (Ahmed: 670, Baerveldt: 561, Ex-PRESS: 473, XEN: 199, trabeculectomy: 1892). Ahmed and Ex-PRESS were similar to trabeculectomy in terms of IOP outcomes and success rate (Ahmed vs trabeculectomy: IOPR%: mean difference (MD)=1.34 (-5.35, 8.02), p=0.69; Ex-PRESS vs trabeculectomy: IOPR%: MD=0.12 (-3.07, 3.31), p=0.94). The IOP outcomes for Baerveldt were worse than those for trabeculectomy (IOPR%: MD=-7.51 (-10.68, -4.35), p<0.00001), but the QSR was higher. No significant difference was shown for the CSR. XEN was worse than trabeculectomy in terms of IOP outcomes (IOPR%: MD=-7.87 (-13.55, -2.18), p=0.007), while the success rate was similar. Ahmed and Ex-PRESS had a lower incidence of AEs than trabeculectomy. Baerveldt had a lower incidence of bleb leakage/wound leakage, hyphaema and hypotonic maculopathy than trabeculectomy but a higher incidence of concurrent cataracts, diplopia/strabismus and tube erosion. The incidence of AEs was similar for the XEN and trabeculectomy procedures.
Compared with trabeculectomy, both Ahmed and Ex-PRESS appear to be associated with similar ocular hypotensive effects and lower incidences of AEs. However, Baerveldt and XEN cannot achieve sufficient reductions in IOP outcomes similar to those of trabeculectomy.
CRD42021257852.
摘要：
目的：比较引流管植入术与小梁切除术治疗青光眼的疗效和安全性。
方法：进行了系统的文献检索，以比较青光眼患者的管和小梁切除术的研究（最终检索日期：2022年2月27日）。管和小梁切除术之间的比较按管的类型进行分组（Ahmed，Baerveldt,Ex-PRESS和XEN）。主要终点包括眼内压（IOP），IOP降低(IOPR),IOPR百分比(IOPR%)，完全成功率(CSR)合格成功率(QSR)和不良事件(AE)。
结果：本荟萃分析纳入了49项研究，并提供了3795只眼的数据（Ahmed：670，Baerveldt：561，Ex-PRESS：473，XEN：199，小梁切除术：1892）。Ahmed和Ex-PRESS在眼压结果和成功率方面与小梁切除术相似(Ahmedvs小梁切除术:IOPR%:平均差异(MD)=1.34(-5.35,8.02),p=0.69;Ex-PRESS与小梁切除术:IOPR%:MD=0.12(-3.07,3.31),p=0.94）。Baerveldt的眼压结果比小梁切除术的眼压结果差（IOPR％：MD=-7.51（-10.68，-4.35），p<0.00001),但QSR更高。CSR没有显示显著差异。就IOP结果而言，XEN比小梁切除术更差（IOPR％：MD=-7.87（-13.55，-2.18），p=0.007),而成功率相似。Ahmed和Ex-PRESS的AE发生率低于小梁切除术。Baerveldt的气泡渗漏/伤口渗漏发生率较低，充血和低张性黄斑病变比小梁切除术，但并发白内障的发病率更高，复视/斜视和输卵管侵蚀。XEN和小梁切除术的AE发生率相似。
结论：与小梁切除术相比，Ahmed和Ex-PRESS似乎都与相似的眼压低血压效应和较低的不良事件发生率相关.然而,Baerveldt和XEN无法实现与小梁切除术相似的IOP结果的足够降低。
■CRD42021257852。
方法：进行了系统的文献检索，以比较青光眼患者的管和小梁切除术的研究（最终检索日期：2022年2月27日）。管和小梁切除术之间的比较按管的类型进行分组（Ahmed，Baerveldt,Ex-PRESS和XEN）。主要终点包括眼内压（IOP），IOP降低(IOPR),IOPR百分比(IOPR%)，完全成功率(CSR)合格成功率(QSR)和不良事件(AE)。
结果：本荟萃分析纳入了49项研究，并提供了3795只眼的数据（Ahmed：670，Baerveldt：561，Ex-PRESS：473，XEN：199，小梁切除术：1892）。Ahmed和Ex-PRESS在眼压结果和成功率方面与小梁切除术相似(Ahmedvs小梁切除术:IOPR%:平均差异(MD)=1.34(-5.35,8.02),p=0.69;Ex-PRESS与小梁切除术:IOPR%:MD=0.12(-3.07,3.31),p=0.94）。Baerveldt的眼压结果比小梁切除术的眼压结果差（IOPR％：MD=-7.51（-10.68，-4.35），p<0.00001),但QSR更高。CSR没有显示显著差异。就IOP结果而言，XEN比小梁切除术更差（IOPR％：MD=-7.87（-13.55，-2.18），p=0.007),而成功率相似。Ahmed和Ex-PRESS的AE发生率低于小梁切除术。Baerveldt的气泡渗漏/伤口渗漏发生率较低，充血和低张性黄斑病变比小梁切除术，但并发白内障的发病率更高，复视/斜视和输卵管侵蚀。XEN和小梁切除术的AE发生率相似。
结论：与小梁切除术相比，Ahmed和Ex-PRESS似乎都与相似的眼压低血压效应和较低的不良事件发生率相关.然而,Baerveldt和XEN无法实现与小梁切除术相似的IOP结果的足够降低。
■CRD42021257852。
