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重复带切除术与在初始失败的带切除手术后的艾哈迈德门植入术的比较

Joshua M Van Swol¹, Delaney N Walden¹, Elizabeth G Van Swol¹

¹Department of Ophthalmology, College of Medicine.

Journal of glaucoma

|June 13, 2023

概括

重复的带切除术在初始眼镜的手术失败后,提供与艾哈迈德膜植入 (AVI) 相似的疗效. 它与较低的并发症率和减少药物需求有关,使其成为潜在的首选选择.

科学领域:

眼科医生眼科眼科
玻璃眼的手术玻璃眼的手术
外科手术的结果

背景情况:

当初始治疗失败时,绿眼的管理往往需要手术干预.
重复带切除术和艾哈迈德植入 (AVI) 是以前失败的玻璃眼手术患者的常见选择.
对这些重新手术的长期疗效和安全性进行比较对于临床决策至关重要.

研究的目的:

为了比较重复带切除术与艾哈迈德植入 (AVI) 的疗效和安全性,在有失败的初级带切除术病史的患者中.
为了评估两种手术方法之间的术后眼内压 (IOP),药物需求和并发症率的差异.

主要方法:

在主要数据库 (PubMed,Cochrane图书馆,Scopus,CINAHL) 进行了系统的文献搜索,寻找相关研究.
包括的研究比较了以先前未能通过mitomycin-C进行的trabeculectomy后,使用mitomycin-C重复trabeculectomy对AVI进行比较.
计划进行元分析,以比较术后IOP,成功率和并发症,尽管成功率分析受到异质性的限制.

主要成果:

在最终分析中包括了14项研究,比较了重复带切除术和AVI.
在手术前或1,2,3年后的组之间没有观察到平均眼内压力 (IOP) 的显著差异.
艾哈迈德膜植入 (AVI) 组在经过1年和2年的术后需要大约两倍的青光眼药物,而不是重复带切除术,在1年后具有意义 (P=0.042).
在AVI组中,整体并发症和视力威胁并发症的累积比例明显高于AVI组.

结论:

重复带切除术和AVI都是在一次失败的初级带切除术后的可行的手术选择.
重复带切除术的疗效与AVI相提并论,但并发症率明显降低, postoperative glaucoma药物的需要减少.
由于其有利的安全性和较低的药物负担,重复带切除术可能是首选的外科选择.

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