非穿透性小梁手术治疗开角型青光眼的Meta分析

目的：对非穿透性小梁手术治疗开角型青光眼的疗效进行Meta分析。方法：检索MEDLINE和中国生物医学文献数据库，获得以往发表的相关论文。根据临床和统计标准进行合并分析，评价非穿透性小梁手术的降压效果。结果：总计有26篇文献纳入Meta分析。无需降压药物治疗而术后眼压控制良好患者的合并百分率：单纯深层巩膜切除术为71．3％95％CI为56．2％～86．5％]，深层巩膜切除术联合胶原植入物为58．5％95％CI为47．8％～69．2％]，深层巩膜切除术联合交键透明质酸植入物为62．0%95％CI为51．0％～73．0％]，粘性小管切除术为69．7％95%CI为50．5％～88．9％]。非穿透性小梁手术和小梁切除术的合并危险差为2％95％CI为-8％0～12％]。结论：非穿透性小梁手术是药物难以控制的开角型青光眼的一种很好的治疗措施，治疗成功率超过60％，眼压控制效果和标准小梁切除术近似。但联合植入物的应用并没有显著改善治疗效果的意义。

Meta analysis of non-penetrating trabecular surgery for open angle glaucoma

Objective: To assess the efficacy of non-penetrating trabecular surgery for open angle glaucoma. Methods: MEDLINE and China Biological Medicine Disk were searched for related clinical trials. The combinability of the studies was assessed in terms of clinical and statistical criteria , and the efficacy of non-penetrating trabecular surgery on intraocular pressure was assessed. Results:A total of 26 studies were included in the meta analysis. The pooled success rate were as follows: deep sclerectomy single, 71. 3% 95% CI 56. 2%-86. 5%]; deep sclerectomy with collagen implant, 58. 5% 95% CI 47. 8%-69. 2%]; deep sclerectomy with reticulated hyaluronic acid implant, 62. 0% 95% CI 51. 0%-73. 0%]; visco-canalostomy, 69. 7% 95% CI 50. 5%-88. 9%]. The pooled risk difference between non-penetrating trabecular surgery and trabeculectomy was 2% 95% CI-8%-12%]. Conclusion: Non-penetrating trabecular surgery is an effective therapy for drug uncontrollable open angle glaucoma, the success rate is beyond 60%, which is the same as trabeculectomy. But the use of implant can not improve success rate of non-penetrating trabecular surgery.