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PreserFlo MicroShunt与带切除术相比:一个更新的元分析和系统审查

Lorenzo Governatori¹, Leandro Oliverio², André Mermoud²

¹Vitreoretinal Surgery Unit, Isola Tiberina - Gemelli Isola Hospital, 00186, Rome, Italy.

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

|October 11, 2024

概括

轨道切除术 (TB) 在2年内对不受控制的青光眼更有效,而PreserFlo (PF) 则提供较低的低垂体风险,并可能有利于那些对视野进展敏感的人. 此外,PF的再干预率也更高.

科学领域:

眼科医生眼科眼科
手术创新在外科创新.
视光眼管理视光眼管理

背景情况:

青光眼的管理通常涉及手术干预以控制眼内压力 (IOP).
PreserFlo (PF) 和带切除术 (TB) 是手术选择,但它们的相对有效性,特别是在中度至高级的青光眼中,需要进一步阐明.
现有的数据呈现了一个关于PF和TB之间最佳手术方法的有争议的景观.

研究的目的:

进行一项元分析,比较PreserFlo MicroShunt (PF) 和轨道切除术 (TB) 的疗效和安全性,用于中度至晚期绿内障患者.
评估关键结果,包括成功率,眼内压力 (IOP) 降低,并发症,重新干预和视野进展.
提供基于证据的见解,比较PF与结核病的益处和风险,以治疗青光眼.

主要方法:

在PubMed,Scopus和Cochrane Central数据库中进行了系统的文献搜索,截至2024年1月13日.
纳入的研究包括随机和非随机试验,最低随访期为2个月.
偏差风险使用ROB-2对RCT和ROBIN-I对非RCT进行评估,并使用漏斗图和埃格尔回归评估出版偏差.

主要成果:

分析了10项涉及1833只眼睛的研究,57.4%接受了PF.
在PF和TB之间没有观察到合格或完全成功率的显著差异.
结核病显示出优异的内血压降低 (MD-2.52 mmHg) 和更好的内血压结果 (MD 1.59 mmHg). PF显示视野进展较少 (MD -1.21) 和低垂巨病变的风险较低 (OR 0.30).
PF的再干预率更高,特别是在没有先前进行眼外科手术或患有初级开角眼的患者中.

结论:

轨道切除术 (TB) 对长达2年的未经控制的青光眼更有效,特别是在针对较低的IOP时.
PreserFlo (PF) 提供了较低的低血压相关事件的风险,并可能有利于对视野损失敏感的患者.
PF与更高的再干预率有关,特别是在特定的患者子组中,突出了个性化外科决策的需要.

关键词:

眼光障碍眼光障碍眼光障碍眼光障碍眼内压力眼内压力这就是 PreserFlo 的原因.骨切除术 (TRABECULECTOMY) 是一种切除骨的方法.

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