可拆除缝线技术在小梁切除术中应用的Meta分析

目的评价传统小梁切除术和术中应用可拆除缝线技术在减少术后浅前房的发生、提高功能性滤过泡成功率及提高长期眼压控制方面的效果。方法计算机检索MEDLINE（1971-2007）、OVID（1971～2007）、国家科技图书文献中心（1971～2007）和中国知网（CNKI，1971-2007），收集有关可拆除缝线在小梁切除术中应用的随机对照试验（RCT）。由两位研究者独立评价纳入研究，交叉核对，而后采用RevMan4．2软件进行Meta分析。结果共纳入6篇RCT，341只眼。与传统小梁切除术相比，术中应用可拆除缝线技术可明显减少术后浅前房的发生RD=-0．23，95％CI（-0．31，-0．14），P〈0．00001]；提高功能性滤过泡成功率RD=-0．15，95％CI（-0．27，-0．02），P=0．02]；但在长期眼压控制上，两组差异无统计学意义SMD=-0．13，95％CI（-0．37，0．10），P=0．27]。结论现有资料表明可拆除缝线可以降低浅前房的发生率，提高功能性滤过泡成功率，但对长期眼压的控制并不优于传统小梁切除术。

Effect of Releasable Sutures on Trabeculectomy: A Meta-Analysis

Objective To evaluate the effect of releasable sutures on shallow anterior chamber, filtering bleb and long-term intraocular pressure （IOP）. Methods We searched MEDLINE （1971 to 2007）, OVID （1971 to 2007） and National Science and Technology Library （1971 to 2007）. Randomized controlled trials （RCTs） of the effect of releasable sutures on trabeculectomy were collected. Study selection and assessment, data collection and analyses were undertaken and cross-checked by two reviewers. Meta-analyses were performed with The Cochrane Collaboration＇s RevMan 4.2.10 software. Results Six RCTs involving 341 eyes were included. Significant differences were observed in the reduction of postoperative shallow anterior chamber （RD -0.23, 95%CI -0.31 to -0.14, P〈0.000 01） and functional filtering blebs （RD -0.15, 95%CI -0.27 to -0.02, P=0.02）. But, no differences were observed for the control of long-term IOP （SMD -0.13, 95%CI -0.37 to 0.10, P=-0.27）. Conclusion The evidence currently available showed that releasable sutures could reduce the incidence of shallow anterior chamber and has no beneficial effect in controlling long-term IOP. The current evidence is insufficient to define the efficacy of maintaining functional filtering blebs. Further large-scale, high-quality randomized controlled trials are needed.