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结合微侵袭性玻璃眼外科手术与在开放角度玻璃眼发酵:一个系统的审查和元分析

Po Hsiang Shawn Yuan¹, Marisa Dorling², Manjool Shah³

¹From the Department of Ophthalmology, Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, Québec (P.H.S.Y., G.M.D.); Department of Ophthalmology and Visual Sciences, Faculty of Medicine (P.H.S.Y.).

American journal of ophthalmology

|August 1, 2024

概括

结合发泡乳化和微创性玻璃眼手术 (MIGS) 对开角玻璃眼患者提供了显著的好处. 这些程序有效降低眼内压力和药物使用,而不会增加视力威胁事件,相比单独的化.

科学领域:

眼科医生眼科眼科
玻璃眼的手术玻璃眼的手术
手术创新在外科创新.

背景情况:

开角玻璃眼 (OAG) 的管理往往需要降低眼内压力 (IOP),以防止视神经受损.
化是一种常见的白内障手术,但可能无法在OAG中充分控制IOP.
微侵袭性玻璃眼手术 (MIGS) 为传统玻璃眼手术提供了不那么侵入性的替代方案或补充.

研究的目的:

在OAG中系统地审查和比较联合发酵-MIGS与单独发酵的疗效和安全性.
评估IOP降低和药物使用作为主要疗效终点.
评估视力威胁和其他不良事件的发生率作为安全终点.

主要方法:

一个系统的审查和对MIGS文章的元分析发表到2024年4月19日.
根据MIGS的机制进行分类:轨道眼网 (TM) 绕道,非镜辅助的透光轨道眼切除术 (非GATT) 和GATT.
通过IOP和药物减少来衡量有效性;通过不良事件率来衡量安全性.

主要成果:

95项对9733只眼睛的研究表明,在1年的随访中,联合的发酵乳化-MIGS有效降低了IOP和药物.
国际贸易协会 (GATT) 显示了最显著的IOP减少,而TM绕道有最低的瘤发病率.
所有MIGS组都表现出与对照组相比,可比或更低的视力威胁事件和二次绿眼瘤手术率.

结论:

结合法化-MIGS为OAG患者提供了显著的疗效益,而不会增加危及视力的并发症.
限制包括研究设计和结果报告的异质性,以及长期后续数据的稀缺性.
目前的证据支持使用联合发酵-MIGS作为OAG.安全和有效的治疗选择.

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