目的:本研究旨在利用现有证据模拟青光眼手术率(GSR),这可以作为西非的目标。
方法:在Medline进行了全面的文献检索,Embase,全球卫生,和CINAHL,并检索了2000年1月1日至2020年6月19日之间发表的研究。研究选择,质量评估,进行了数据提取,并使用叙述性综合汇总并呈现了各个研究的结果。利用这些数据,我们的目标是建立一个每年每百万人口的目标GSR,足以为大多数确诊的青光眼患者提供小梁切除术,以及其他治疗方案无效或不合适的人。然后将研究结果用于开发西非的小梁切除术目标。
结果:初始搜索返回633个引用,其中33项独特研究符合纳入条件.青光眼患病率基于人群的调查确定,报告了原发性开角型青光眼(POAG)的广泛患病率,范围为1.0%至8.4%。对青光眼药物的研究报告了降低眼内压(IOP)的作用,范围从12.8%(β-受体阻滞剂)到63.7%(噻吗洛尔-拉坦前列素组合)。抗青光眼药物的依从率为10.3%至82.3%。关于选择性激光小梁成形术(SLT),只有两项研究被发现。所有关于小梁切除术的研究表明,在不同的随访期间,IOP显着降低,许多报告没有威胁视力的并发症。从这些现有数据来看,建议在西非国家进行50例小梁切除术的GSR。
结论:此小梁切除术目标指标有望在西非次区域减少POAG失明。
结论:拟议的GSR将使参与西非青光眼护理的眼护理人员能够与拟议的目标进行比较,评估他们的努力。差距将预示着改进的潜力。
■EniEN,诺兰W,EvalB,etal.什么青光眼手术率可以作为西非的目标?系统评价。JCurr青光眼Pract2021;15(1):19-27。
OBJECTIVE: This study aimed to use the available evidence to model a glaucoma surgical rate (GSR), which could serve as a target for West Africa.
METHODS: A comprehensive literature search was performed in Medline, Embase, Global Health, and CINAHL, and studies published between January 1, 2000, and June 19, 2020, were retrieved. Study selection, quality appraisal, and data extraction were performed and the results of individual studies aggregated and presented using a narrative synthesis. Using these data, we aimed to construct a target GSR per million population per year that is sufficient to offer trabeculectomy to most patients with glaucoma who are diagnosed, and for whom other treatment options are either ineffective or inappropriate. The findings were then used to develop a trabeculectomy target for West Africa.
RESULTS: Initial searches returned 633 references, of which 33 unique studies were eligible for inclusion. The glaucoma prevalence population-based surveys identified, reported a wide range of prevalence of primary open-angle glaucoma (POAG) ranging from 1.0 to 8.4%. The studies on glaucoma medications reported intraocular pressure (IOP)-lowering effects ranging from 12.8% (beta-blockers) to 63.7% (Timolol-Latanoprost combinations). The adherence rate to antiglaucoma medications spanned from 10.3 to 82.3%. Regarding selective laser trabeculoplasty (SLT), only two studies were found. All the studies on trabeculectomy showed a significant reduction in IOPs at different follow-up periods with many reporting the absence of vision-threatening complications. From these available data, a GSR of 50 trabeculectomies was suggested for countries in West Africa.
CONCLUSIONS: This trabeculectomy target metric is expected to minimize POAG blindness in the West African subregion.
CONCLUSIONS: The proposed GSR will enable eye care workers involved in glaucoma care in West Africa to assess their efforts compared with the proposed target. The gap will signal the potential for improvement.
UNASSIGNED: Eni EN, Nolan W, Eval B, et al. What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic
Review. J Curr Glaucoma Pract 2021;15(1):19-27.