小梁切除术分别联合Ologen植入与丝裂霉素C治疗青光眼的有效性和安全性对比分析

目的　对比分析小梁切除术分别联合Ｏｌｏｇｅｎ植入与丝裂霉素Ｃ（ｍｉｔｏｍｙｃｉｎＣ，ＭＭＣ）治疗青光眼的有效性和安全性。方法　利用计算机检索Ｍｅｄｌｉｎｅ、ＥＭＢＡＳＥ、ＷｅｂｏｆＳｃｉｅｎｃｅ、ＣｏｃｈｒａｎｅＣｅｎｔｒａｌｏｆＣｏｎｔｒｏｌｌｅｄＴｒｉａｌｓ、ＧｏｏｇｌｅＳｃｈｏｌａｒ等数据库，检索时间均从建库至２０１４年１月，并追溯纳入文献的参考文献。将获得的临床对照研究，通过纳入和排除标准限定，经质量评价后，采用ＲｅｖＭａｎ５．０软件进行Ｍｅｔａ分析。结果　纳入６篇临床对照研究（小梁切除术联合Ｏｌｏｇｅｎ植入组１１４例，小梁切除术联合ＭＭＣ组１２３例），质量评分均大于１６分，为高质量文献。Ｍｅｔａ分析结果显示，Ｏｌｏｇｅｎ植入组术后患者眼压减低，但眼压降低百分率与ＭＭＣ治疗组相比无明显差异。两组在青光眼药物种数治疗减少、手术成功率及术后并发症发生率等方面亦无明显差异。结论　小梁切除术联合Ｏｌｏｇｅｎ植入治疗青光眼在长期眼压控制成功率方面与小梁切除术联合ＭＭＣ治疗效果相当，在避免ＭＭＣ治疗引发的术后并发症方面无明显优势。

Comparison of efficacy and safety between trabeculectomy with Ologen implant and mitomycin C:A Meta-analysis

Objective To systematically compare the efficacy and safety of trabeculectomy with Ologen implant and mitomycin C ( MMC) for glaucoma. Methods Such databases as Medline , EMBASE . Web of Science , Cochrane Central of Controlled Trials , Google Scholar were searched until January 2014 , also the references of included studies were traced. The controlled trials on trabeculectomy + Ologen vs. trabeculectomy + MMC for glaucoma after study selections were scored highly by Downs and Blacks score. Then meta-analysis was performed using RevMan 5. 0 software. Results Six studies involved 114 eyes on trabeculectomy + Ologen and 123 eyes on trabeculectomy + MMC were included in our study. Each study had a score > 16 points. The results of meta-analysis showed that Ologen implant was associated with a numerically low IOP , but no significant percentage reduction in IOP compared with MMC. There was no significant difference in the reduction of glaucoma medications . success rate . and incidence of complications. Conclusion Trabeculectomy with Ologen implant is comparable to the use of MMC with a similar long-term success rate. However.it does not seem to offer significant advantages of avoiding the potential complications related to MMC.