背景:尽管最近有很多进展,选择不受控制的眼内压(IOP)的手术治疗仍是一个挑战.
目的:本研究比较了内镜下睫状体光凝(ECP)与其他外科手术的临床疗效和安全性,所有类型的青光眼。
方法:该方法符合系统评价的首选报告项目和系统评价报告的荟萃分析指南。报道ECP和替代手术治疗难治性青光眼的研究,新生血管性青光眼,无晶状体青光眼,滤过手术失败的青光眼,先天性或幼年性青光眼,继发性青光眼如葡萄膜炎青光眼,外伤性青光眼,角膜移植术后继发性青光眼,等。包括在内。从降低IOP药物的数量来评估疗效,和IOP前后的平均变化是本综述评估的ECP和非ECP组的结局.术后并发症的评估显示了该手术的安全性评估。
结果:总计,本研究共选择了11项相关研究,共5418只眼,其中ECP组763只眼,非ECP组4655只眼。这篇综述观察到ECP和非ECP手术均成功降低了术后眼压。
结论:从这篇综述中可以推断出,所有类型的青光眼都可以有效治疗,ECP和ECP的成功率明显更高,与非ECP手术相比,ECP的术后并发症最低。这篇综述提供了最新的科学证据,以支持青光眼手术治疗的临床决策。
BACKGROUND: Despite many recent developments, preference in the choice of surgical treatment of uncontrolled intraocular pressure (IOP) remains a challenge.
OBJECTIVE: This study compares the clinical efficacy and safety of endoscopic cyclophotocoagulation (ECP) to alternative surgical procedures, for all types of glaucoma.
METHODS: The methodology adheres to the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic
review reporting. Studies reporting ECP and alternative surgeries in treating refractory glaucoma, neovascular glaucoma, aphakic glaucoma, filtering surgical failure-induced glaucoma, congenital or juvenile glaucoma, and secondary glaucoma such as uveitis glaucoma, traumatic glaucoma, secondary glaucoma postcorneal transplantation, etc. were included. The efficacy was evaluated from the number of IOP-lowering drugs, and mean change in pre- and post-IOP were the outcomes assessed in ECP and non-ECP groups in this
review. Evaluations of the postoperative complications revealed the safety assessment of the procedure.
RESULTS: In total, 11 relevant studies were selected in this study with a total of 5418 eyes, including 763 eyes in the ECP group and 4655 in the non-ECP group. This
review observed that both ECP and non-ECP procedures had been successful in reducing postoperative IOP.
CONCLUSIONS: It can be deduced from this
review, that all types of glaucoma can be treated efficiently with significantly higher success rates with ECP and ECP demonstrates lowest postoperative complications when compared to non ECP procedures. This
review provides updated scientific evidence which caters to support clinical decisions for surgical treatment of glaucoma.