| 摘要: |
| 目的评价非穿透性小梁手术联合使用丝裂霉素C对治疗开角型青光眼患者的疗效及耐受性的差异。方法检索MEDLINE、EMBASE、中国生物医学文献数据库、Cochrane图书馆,获得以往发表的相关论文,经筛选后共有8项临床对照试验纳入meta分析。比较非穿透性小梁手术联合使用与未使用丝裂霉素C的眼压下降百分比、治疗完全成功率、治疗总成功率和并发症等指标。使用RevMan 5.0软件进行统计分析。结果术后6、12、24、36个月非穿透性小梁手术联合使用丝裂霉素C组与单纯非穿透性小梁手术组眼压下降百分比的加权均数差分别为5.24%(95%CI,-3.24~13.72)、8.31%(95%CI,4.33~12.30)、9.56%(95%CI,4.88~14.24)、14.45%(95%CI,9.02~19.88),除术后6个月外的其余各个时间点两组之间差异均存在统计学意义(P<0.05)。非穿透性小梁手术联合使用丝裂霉素C组的治疗完全成功率较单纯非穿透性小梁手术组增加,治疗完全成功率的合并风险差在术后6、12、24、36个月分别为1.16(95%CI,1.05~1.27)、1.20(95%CI,1.05~1.38)、1.30(95%CI,1.05~1.61)、1.36(95%CI,1.06~1.73),各个时间点两组之间差异均存在统计学意义(P<0.05)。术中应用丝裂霉素C未出现与药物相关的并发症。结论联合应用丝裂霉素C可以改善非穿透性小梁手术的疗效,而且耐受性良好。 |
| 关键词: 开角型青光眼 非穿透性小梁手术 丝裂霉素C meta分析 |
| DOI：10.3724/SP.J.1008.2012.001006 |
| 投稿时间：2012-04-06修订日期：2012-05-16 |
| 基金项目:国家自然科学基金(81000374,81170874),上海市自然科学基金(10ZR1439300),上海市青年科技启明星计划(12QA1404600). |
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| Intra-operative mitomycin C for nonpenetrating filtering surgery in treatment of open angle glaucoma: a systematic review and meta-analysis |
| SHEN Ya△,GAO Lian-di△,CHENG Jin-wei,CAI Ji-ping,LI You,WEI Rui-li* |
(Department of Ophthalmology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
△Co-first authors.
*Corresponding author.) |
| Abstract: |
| ObjectiveTo compare the efficacy and tolerability between nonpenetrating filtering surgery with (NPFS-MMC) and without (NPFS-noMMC) intraoperative mitomycin C application for treatment open angle glaucoma. MethodsPertinent studies were selected through extensive searches of the Cochrane Library, PubMed, Embase, and Chinese Biomedicine Database. Eight controlled clinical trials meeting the pre-defined criteria were systematically reviewed by meta-analysis. The main outcome measures were percentage intraocular pressure reduction (IOPR%), complete remission rate, total remission rate, and complications. The pooled estimates were carried out using RevMan version 5.0 software. ResultsThe weighted mean differences of the IOPR% between the NPFS-MMC group and NPFS-noMMC group were 5.24% (95% confidence intervals\[95%CI\], -3.24 to 13.72) after 6 months, 8.31% (95%CI,4.33 to 12.30) after 12 months(P<0.05), 9.56% (95%CI, 4.88 to 14.24) after 24 months(P<0.05), and 14.45% (95%CI, 9.02 to 19.88) after 36 months(P<0.05). NPFS-MMC was associated with significant greater complete remission rates compared with NPFS-noMMC, with the pooled risk difference being 1.16 (95%CI, 1.05 to 1.27) after 6 months(P<0.05), 1.20 (95%CI, 1.05 to 1.38) after 12 months (P<0.05), 1.30 (95%CI, 1.05 to 1.61) after 24 months (P<0.05), and 1.36 (95%CI, 1.06 to 1.73) after 36 months (P<0.05). Intraoperative mitomycin C was not associated with any drug-induced complications. ConclusionThe use of intraoperative mitomycin C is safe and can improve the effect of nonpenetrating filtering surgery in patients with open ganle glaucoma. |
| Key words: open-angle glaucoma nonpenetrating filtering surgery mitomycin C meta-analysis |
