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发光乳化与激光外周虹膜切除术用于治疗初级角闭眼镜:系统性审查和元分析
Rahaf K Sharif1, Faisal F Aljahdali1, Hind M Aljabri1
1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Clinical ophthalmology (Auckland, N.Z.)
|April 10, 2024
概括
化比激光外周 iridotomy (LPI) 更有效地减少角膜厚度和内皮细胞的损失在初级角度闭合光眼 (PACG). 然而,这两种治疗方法在眼内压和青光眼的进展方面都显示出类似的结果.
科学领域:
- 眼科医生 眼科 眼科
- 玻璃眼研究研究 玻璃眼研究
- 手术干预 手术干预
背景情况:
- 初级角关闭性玻璃眼 (PACG) 是由虹膜角缩小而产生的,增加了轨道眼网格堵塞的风险.
- 化和激光外周虹膜切除术 (LPI) 是用于控制眼内压力 (IOP) 和在PACG中扩大虹膜角的已建立的治疗方法.
研究的目的:
- 进行系统性审查和元分析,比较化与LPI的有效性,以管理PACG.
- 评估关键结果,包括IOP,药物使用,视力敏度,视野进展和手术并发症.
主要方法:
- 在Medline,Embase和CENTRAL搜索相关的随机对照试验 (RCT).
- 包括5项与917名参与者进行的RCT,比较PACG患者的发酵乳化和LPI.
- 分析了使用标准化平均差异 (SMD) 的连续结果和使用风险比率 (RR) 的二分结果.
主要成果:
- 与LPI相比,化表明中枢角膜厚度 (CCT) 和中枢内皮细胞密度 (CECD) 显著降低.
- 在发酵化组中,手术反应不佳的风险显著降低.
- 两组之间没有观察到关于平均内皮压,青光眼药物数量,视敏度 (VA),视野 (VF) 进展,外围前侧突 (PAS) 或沙弗尔视镜分级的显著差异.
结论:
- 在保持角膜完整性和降低PACG手术失败的可能性方面,法化比LPI具有优势.
- 尽管角膜参数有差异,但化和LPI都提供了可比的IOP控制,并且在视觉结果或青光眼进展方面没有显著差异.
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