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卡胡克双刀子利切割与iStent植入结合法化:系统性审查和元分析

Jaime Guedes¹, Dillan Cunha Amaral², Karina de Oliveira Caneca²

¹Glaucoma Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University.

Journal of glaucoma

|December 6, 2024

概括

卡胡克双刀片 (KDB) 阴茎切除术在6个月后显示出更高的手术成功率和更好的眼内压力 (IOP) 降低,相比于iStent植入与法化. 在KDB和iStent注射器之间,长期的内脏压力减少是相似的.

科学领域:

眼科医生眼科眼科
玻璃眼的手术玻璃眼的手术
最少侵入性玻璃眼外科手术 (MIGS)

背景情况:

青光眼的治疗通常需要进行手术以降低眼内压力 (IOP).
与MIGS手术相结合的法化,如Kahook双刀片 (KDB) 阴茎切除术或带微绕道支架 (iStent/iStent注射) 是常见的治疗选择.

研究的目的:

进行一项元分析,比较KDB阴茎切除与iStent或iStent注射植入相结合的化疗法的疗效和安全性.
为了评估两个手术方法之间的手术成功率,眼内压 (IOP) 降低,药物使用和并发症率.

主要方法:

在主要数据库 (PubMed,Embase,Web of Science,Cochrane Library) 进行了全面的文献搜索,截至2024年4月.
包括的研究是随机临床试验和观察性研究,比较了法科-KDB阴茎切割与法科-斯坦特 (iStent/iStent注射) 程序.
主要结局包括手术成功,内血压的平均变化,药物数量和并发症率,使用汇总的几率比率和平均差异进行分析.

主要成果:

分析包括14项研究,包括1959只眼睛;958个在法可-KDB组和1000个在法可-支架组.
与phaco-Stent相比,Phaco-KDB显示了显著更高的手术成功率 (OR:0.68) 和在6个月后更大的IOP降低 (MD:1.13 mm Hg).
在12个月后,法科-KDB显示了比法科-iStent (MD: 1.69 mm Hg) 更大的内脉压降低,但与法科-iStent注射相似的降低. 药物使用和不良事件是可比的.

结论:

卡胡克双刀片 (KDB) 阴茎切除术与发泡乳化相结合,似乎提供了优越的外科成功率,相比于状微绕道支架植入.
与第一代iStent相比,KDB骨髓切割在12个月内能更好地减少内膜压力,结果与iStent注射器相似.
无论是KDB阴茎切除术还是iStent注射都显示出有希望的结果,为玻璃眼癌管理提供了有价值的选择.

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