论文部分内容阅读
目的 系统评价超声乳化联合小梁切除术与单纯超声乳化术比较治疗原发性闭角型青光眼合并白内障的有效性和安全性.方法 计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI、VIP和WanFang Data,搜集超声乳化联合小梁切除术与单纯超声乳化术比较治疗原发性闭角型青光眼合并白内障的随机对照试验(RCT),检索时间从建库至2017年5月.由2位研究者独立进行文献筛选、资料提取和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入8个研究,包括679例患者.Meta分析结果显示:超声乳化联合小梁切除术组与单纯超声乳化术在术后视力[MD=0.00,95％CI(-0.10,0.09),P=0.98]、术后前房深度[MD=0.14,95％CI(-0.17,0.45),P=0.37]和不良反应发生率[视神经损伤:RR=l.56,95％CI (0.70,3.47),P=0.28;视野缺损:RR=l.43,95％CI (0.70,2.92),P=0.33;角膜水肿:RR=0.57,95％CI (0.25,1.32),P=0.19]方面差异均无统计学意义.结论 当前证据表明,超声乳化联合小梁切除术与单纯超声乳化术在治疗原发性闭角型青光眼合并白内障方面疗效和安全性相当.受纳入研究数量和质量的限制,上述结论尚需大样本高质量临床研究予以证实.“,”Objective To systematically review the efficacy and safety of phacoemulsification combined with trabeculectomy versus simple phacoemulsification for primary angle closure glaucoma with cataract.Methods Databases including PubMed,EMbase,The Cochrane Library,CBM,CNKI,VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about phacoemulsification combined with trabeculectomy vs.simple phacoemulsification for primary angle closure glaucoma with cataract from inception to May 2017.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then meta-analysis was conducted by RevMan 5.3 software.Results A total of eight studies involving 679 patients were included.The results of meta-analysis showed that:there were no significant differences between two groups in postoperative visual acuity (MD=0.00,95％CI-0.10 to 0.09,P=0.98),postoperative anterior chamber depth (MD=0.14,95％CI-0.17 to 0.45,P=0.37) and adverse reactions rates (optic nerve injury:RR=1.56,95％CI 0.70 to 3.47,P=0.28;visual field defect:RR=1.43,95％CI 0.70 to 2.92,P=0.33;corneal edema:RR=0.57,95％CI 0.25 to 1.32,P=0.19).Conclusion Current evidence shows that phacoemulsification combined with trabeculectomy and simple phacoemulsification has the similar efficacy and safety for primary angle closure glaucoma with cataract.Due to limited quantity and quality of the included studies,the above conclusions still need to be verified by more high quality studies.