Abstract:
To perform a meta-analysis to compare the efficacy and safety of diode laser transscleral cyclophotocoagulation (TSCPC) and cyclocryotherapy (CCT) in the treatment of intractable glaucoma. Systemic searches of the Ovid MEDLINE, EMBASE, and Cochrane Library databases yielded experimental and observational comparative studies. TSCPC and CCT efficacy and safety outcomes were compared. Subgroup analyses of participant ethnicity, preoperative intraocular pressure (IOP) level, and underlying causes of glaucoma were conducted. The pooled effects were computed using the random-effects model. The meta-analysis included nine studies totalling 668 eyes. There was no statistically significant difference between the TSCPC and CCT groups in the IOP reduction (IOPR%), decrease in antiglaucoma medications, the operative success rate with or without medications, or retreatment rate in the efficacy analysis. In the subgroup analysis, CCT had a better IOP-lowering effect among non-Asian participants and a non-inferior IOPR% to TSCPC among Asian participants. TSCPC and CCT were associated with similar rates of deterioration in visual acuity, postoperative visual analog scale, and other analysed postoperative complications in the safety analysis. In both groups, severe complications were uncommon. Diode laser TSCPC and CCT had nearly equivalent clinical efficacy in treating intractable glaucoma, while CCT demonstrated a better IOP-lowering effect in non-Asian. Both cyclodestructive procedures have a comparable safety profile.
摘要:
进行荟萃分析,比较二极管激光经巩膜睫状体光凝术(TSCPC)和睫状体疗法(CCT)治疗难治性青光眼的疗效和安全性。OvidMEDLINE的系统搜索,EMBASE,和Cochrane图书馆数据库进行了实验和观察性比较研究。比较TSCPC和CCT疗效和安全性结果。参与者种族的亚组分析,术前眼压(IOP)水平,和青光眼的潜在原因进行了研究。使用随机效应模型计算合并效应。荟萃分析包括9项研究,共668只眼睛。TSCPC组和CCT组眼压降低(IOPR%)无统计学差异,减少抗青光眼药物,有或没有药物的手术成功率,或疗效分析中的再治疗率。在亚组分析中,在非亚洲参与者中,CCT具有更好的降低IOP的作用,而在亚洲参与者中,与TSCPC相比,CCT具有更好的IOPR%。TSCPC和CCT与相似的视力下降率相关,术后视觉模拟量表,等分析术后并发症的安全性分析。在这两组中,严重并发症并不常见.二极管激光TSCPC和CCT治疗难治性青光眼的临床疗效几乎相当,而CCT在非亚洲人群中表现出更好的降低IOP的作用。两种循环破坏程序都具有可比的安全性。