CAJ | 학술논문

目的：比较单切口和双切口白内障超声乳化术联合青光眼小梁切除手术的有效性和安全性。方法检索数据库，包括PUBMED、EMBASE、Cochrane Library、中国知网、维普、万方数据，检索时间范围1998年1月1日-2014年12月31日。文献入选标准：单切口和双切口白内障超声乳化术联合青光眼小梁切除手术随机对照试验，随访时间至少12个月，语言为英文和中文。对符合入选标准的文献进行评估、筛选，提取数据进行合并分析。有效性定义为术后的眼压水平和所需抗青光眼药物数量；安全性定义为术中和术后不良事件的多少，包括术中晶状体后囊膜破裂发生率和术后前房出血、低眼压、结膜/滤过泡渗漏、浅前房、脉络膜渗漏/脱离、后囊膜混浊/需要激光囊膜切开的发生率等。结果5篇文献最终纳入分析，均为英文文献。单切口组(n=251)与双切口组(n=252)的术后眼压差异无统计学意义(I2=46%，P=0.08)，术后抗青光眼药物数量差异无统计学意义(I2=0，P=0.10)，单切口组手术时间少于双切口组(I2=95%，P=0.0006)。两组的晶状体后囊膜破裂发生率和术后前房出血、低眼压、结膜/滤过泡渗漏、浅前房、脉络膜渗漏/脱离、后囊混浊/需要激光囊膜切开的发生率差异均无统计学意义(P＞0.05)。两组术后视力均高于术前。结论单切口与双切口白内障超声乳化术联合青光眼小梁切除手术的有效性和安全性相当。
목적：비교단절구화쌍절구백내장초성유화술연합청광안소량절제수술적유효성화안전성。방법검색수거고，포괄PUBMED、EMBASE、Cochrane Library、중국지망、유보、만방수거，검색시간범위1998년1월1일-2014년12월31일。문헌입선표준：단절구화쌍절구백내장초성유화술연합청광안소량절제수술수궤대조시험，수방시간지소12개월，어언위영문화중문。대부합입선표준적문헌진행평고、사선，제취수거진행합병분석。유효성정의위술후적안압수평화소수항청광안약물수량；안전성정의위술중화술후불량사건적다소，포괄술중정상체후낭막파렬발생솔화술후전방출혈、저안압、결막/려과포삼루、천전방、맥락막삼루/탈리、후낭막혼탁/수요격광낭막절개적발생솔등。결과5편문헌최종납입분석，균위영문문헌。단절구조(n=251)여쌍절구조(n=252)적술후안압차이무통계학의의(I2=46%，P=0.08)，술후항청광안약물수량차이무통계학의의(I2=0，P=0.10)，단절구조수술시간소우쌍절구조(I2=95%，P=0.0006)。량조적정상체후낭막파렬발생솔화술후전방출혈、저안압、결막/려과포삼루、천전방、맥락막삼루/탈리、후낭혼탁/수요격광낭막절개적발생솔차이균무통계학의의(P＞0.05)。량조술후시력균고우술전。결론단절구여쌍절구백내장초성유화술연합청광안소량절제수술적유효성화안전성상당。
Objective To observe the efficacy and safety of 1-site versus 2-site phacotrabeculectomy in eyes coexisting with cataract and glaucoma. Methods Randomized controlled trials about one-site versus two-site trabiculectomy with a minimum follow-up of 12 months were searched from January 1, 1998 to December 31, 2014 in database of PUBMED, EMBASE, Cochrane Library, CNKI, CNVIP, WANFANG DATA. Articles up to the standard were reviewed and selected and data were analyzed. The effectiveness was defined as intraocular pressure (IOP), number of antiglaucoma medication, and safety was defined as adverse events, intraocular posterior capsular rupture, postoperative hyphema, intraocular hypotension, conjuntival/bleb leakage, shallow anterior chamber, choidal effusion/detachment, posterior capsular opacification/laser capsulotomy.Results Five articles were included in this meta-analysis. There were no differences in postoperative intraocular pressure (I2=46%,P=0.08) and antiglaucoma medication (I2=0, P=0.10) between 1-site group (n=251) and 2-site group (n=252), or in intraocular posterior capsular rupture, postoperative hyphema, intraocular hypotension, conjuntival/bleb leakage, shallow anterior chamber, choidal effusion/detachment, posterior capsular opacification/laser capsulotomy (P>0.05). Visual acuity was better postoperatively than preoperatively in two groups. One-site surgery was less time-consuming (I2=95%, P=0.000 6).Conclusion There are no differences between one-site and two-site phacotrabeculectomy in term of efficacy and safety after a minimum follow-upof twelve months.