Abstract：
To compare the safety and efficacy of the Preserflo Microshunt with trabeculectomy in the treatment of patients with glaucoma. A systematic review and meta-analysis was conducted. The primary outcome measures recorded as a measure of efficacy of the interventions were intra-ocular pressure (IOP) at final follow-up and IOP reduction (IOPR). Secondary outcomes recorded to measure efficacy were reduction in the number of glaucoma medications and reinterventions. To assess safety profile, the proportions of patients with post-operative complications were recorded. Seven articles were included in this study. A total of 1353 eyes were included in this review (Preserflo: 812, trabeculectomy: 541). Post-operative IOP (mean difference [MD] = 0.78 [0.66, 0.90], p < 0.001) results are significantly lower for trabeculectomy than Preserflo. The IOPR (MD = -1.20 [-2.30, -0.09], p = 0.034) results significantly favour trabeculectomy over Preserflo Microshunt. The reduction in topical glaucoma medications (MD = -0.32 [-0.58, -0.07], p = 0.014) is significantly higher for trabeculectomy. There is no statistically significant difference in levels of hypotony (risk ratio [RR] = -0.05 [-0.47, 0.37], p = 0.806), choroidal effusion/detachment (RR = -0.12 [-0.42, 0.19], p = 0.444), hyphaema (RR = 0.20 [-0.11, 0.51], p = 0.216) and flat anterior chamber (RR = 0.49 [-1.02, 0.03], p = 0.066). There are significantly more bleb-related complications in the trabeculectomy groups than Preserflo groups (RR = -0.63 [-1.01, -0.24], p = 0.001). There were statistically more reinterventions required in the trabeculectomy groups than Preserflo groups (RR = -0.48 [-0.65, -0.30], p < 0.001). Compared to trabeculectomy, the Preserflo Microshunt is not as effective in lowering intra-ocular pressure, has a similar safety profile and has a lower reintervention rate. Further research is required given the lack of randomised controlled trials within this study and resulting low strength of evidence.
摘要：
目的比较普氏微分流术与小梁切除术治疗青光眼患者的安全性和疗效。进行了系统评价和荟萃分析。记录为干预措施有效性的主要结果指标是最终随访时的眼内压（IOP）和IOP降低（IOPR）。记录的衡量疗效的次要结果是青光眼药物和再干预的数量减少。为了评估安全性，记录术后并发症患者的比例.本研究包括七篇文章。本综述共包括1353只眼（保留：812，小梁切除术：541）。术后眼压（均差[MD]=0.78[0.66,0.90]，p<0.001）小梁切除术的结果明显低于Preservflo。IOPR（MD=-1.20[-2.30，-0.09]，p=0.034）的结果显着有利于小梁切除术，而不是保留膜微分流术。局部青光眼药物的减少（MD=-0.32[-0.58，-0.07]，对于小梁切除术，p=0.014）明显更高。低张力水平无统计学差异（风险比[RR]=-0.05[-0.47,0.37]，p=0.806),脉络膜积液/脱离（RR=-0.12[-0.42,0.19]，p=0.444),充血（RR=0.20[-0.11，0.51]，p=0.216）和平坦前房（RR=0.49[-1.02，0.03]，p=0.066)。小梁切除术组的气泡相关并发症明显多于Preservflo组(RR=-0.63[-1.01,-0.24],p=0.001)。在统计学上，小梁切除术组比Preservflo组需要更多的再干预（RR=-0.48[-0.65,-0.30]，p<0.001)。与小梁切除术相比,Preservflo微分流术在降低眼内压方面效果不佳，具有相似的安全性，并且具有较低的再干预率。鉴于本研究中缺乏随机对照试验，并且导致证据强度低，因此需要进一步的研究。
