山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (5): 84-90.doi: 10.6040/j.issn.1673-3770.0.2013.023

• 论著 • 上一篇    下一篇

原发性闭角型青光眼合并白内障手术方式的系统评价

时少丹1,刘景2,张伟2 ,张晗2   

  1. 1.沧州市人民医院眼科, 河北  沧州 061000;  2.山东大学第二医院眼科, 济南 250033
  • 收稿日期:2013-01-16 出版日期:2013-10-16 发布日期:2013-10-16
  • 通讯作者: 张伟,教授,主任医师。 Email:zhangwei0860@126.com
  • 作者简介:时少丹。 Email:shishaodan0306@163.com

Systematic review of surgical treatment for primary angle-closure glaucoma accompanied with Cataract

SHI Shao-dan1, LIU Jing2, ZHANG Wei2, ZHANG Han2   

  1. Department of Ophthalmology, 1. Cangzhou People′s Hospital, Cangzhou 061000, Hebei, China; 2. The Second Hospital of Shandong University, Jinan 250033,  China
  • Received:2013-01-16 Online:2013-10-16 Published:2013-10-16

摘要:

目的   对原发性闭角型青光眼合并白内障手术方式进行循证医学系统评价,为手术方式选择提供循证医学证据。方法     按照循证医学系统评价要求,检索PubMed、EMBASE、Cochrane Library及CNKI和CBM发表的相关中、英文文献(2005.01~2011.07)。观察指标包括治疗前后视力、眼压、眼压控制成功率、视野损害进展、RNFL、房角粘连变化、并发症等。结果      共10篇英文和13篇中文文献入选。其中Ⅰ~Ⅱ级证据11篇, Ⅲ级证据7篇, Ⅳ级证据5篇,涉及手术方式包括:LPI、SPI、ECCE、Phaco、Phaco-GSL、Phaco+SPI、PhacoTrab+IOL及小梁切除术。结论      循证医学系统评价证实超乳手术可作为PACG合并白内障手术方式。手术适应证方面临床需要进一步大样本、多中心RCT研究,建议研究中纳入有关视神经损害及长期降眼压效果的观察指标。

关键词: 白内障, 青光眼, 治疗, 系统综述

Abstract:

Objective      To make an evidence-based assessment oo the surgical treatment for primary angle-closure glaucoma accompanied with cataract. Methods      According to the evidence-based principles,  studies published in the English language in PubMed, EMBASE, and Cochrane Library, as well as those in the Chinese language in journals of Chinese Periodical Fulltext Database and Chinese Bio-medicine Database, from Jan. 2005 to Jul. 2011, were searched and selected. Outcome measures consisted of visual acuity, intraocular pressure(IOP), success rate of controlling IOP, progression in visual field loss, Thickness of retinal nerve fiber layer (RNFL), goniosynechia, UBM, complications, et al. Results       Ten articles in English and thirteen articles in Chinese were eligible, in which eleven were in gradeⅠ-Ⅱ, seven were in grade Ⅲ, and five were in grade Ⅳ. The interventions included LPI,SPI, ECCE, Phaco,Phaco-GSL,Phaco+SPI, PhacoTrab+IOL and trabeculectomy. Conclusion       Evidence-based medicine assessment suggested that phacoemulsification could be the good choice in the surgical treatment for PACG accompanied with cataract. Randomized controlled trials of large samples and multi-center study are needed. Meanwhile, damage of optic nerve and long-term follow-up on postoperative intraocular pressure should be investigated in the further research.

Key words: Cataract, Systematic review, Glaucoma, Treatment

中图分类号: 

  • R775.2
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