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目的:评价并比较一切口和二切口超声乳化白内障吸除术联合小梁切除术治疗白内障合并青光眼的疗效和耐受性。方法:按照Cochrane协作网方法全面检索符合纳入标准的比较一切口和二切口超声乳化白内障吸除术联合小梁切除术的临床对照研究,将其进行荟萃分析。临床疗效的评估包括:眼压下降百分比采用标准化均差(SMD),术后最佳矫正视力≥0.5的患者百分比采用比值比(OR),手术成功率采用相对危险度(RR)。临床耐受性的评估采用RR。所有结果均以95%可信区间表示。数据分析采用Stata10.1。结果:降低眼压的临床疗效二切口术式明显优于一切口术式,差异具有统计学意义(SMD,-0.19;95%CI,-0.33到-0.04;P=0.01);术后最佳矫正视力≥0.5的患者百分比二切口术式大于一切口术式,但差异不具有统计学意义(OR,0.65;95%CI,0.30到1.39;P=0.26);术后不加用抗青光眼药物达到靶眼压的患者百分比二切口术式大于一切口术式,但差异不具有统计学意义(RR,0.94;95%CI,0.84到1.04;P=0.22);两种术式在术后并发症方面差别无统计学意义。结论:二切口超声乳化白内障吸除术联合小梁切除术临床疗效优于一切口术式。两种术式的术后并发症没有明显差异。
OBJECTIVE: To evaluate and compare the efficacy and tolerability of phacoemulsification combined with trabeculectomy in the treatment of cataract combined with glaucoma. METHODS: A full-scale follow-up of the Cochrane Collaboration was used to perform a meta-analysis of controlled trials comparing matched-incision-matched and two-incision phacoemulsification cataract surgery with trabeculectomy. Assessments of clinical efficacy included a percentage reduction in IOP using standardized mean deviation (SMD), postoperative best corrected visual acuity ≥ 0.5 using odds ratio (OR), and surgical success using relative risk (RR). Clinical tolerance was assessed using RR. All results are 95% confidence interval. Data analysis using Stata10.1. Results: The clinical curative effect of reducing intraocular pressure was better than that of one incision. The difference was statistically significant (SMD, -0.19; 95% CI, -0.33 to -0.04; P = 0.01) The percentages of patients with corrected visual acuity≥0.5 were higher than those of one incision, but the difference was not statistically significant (OR, 0.65; 95% CI, 0.30 to 1.39; P = 0.26); no postoperative anti-glaucoma medication The percentage of patients who reached the target IOP was greater than an incision in the two incisions, but the difference was not statistically significant (RR, 0.94; 95% CI, 0.84 to 1.04; P = 0.22) No significant difference in disease. Conclusion: The clinical effect of two incision phacoemulsification combined with trabeculectomy is superior to one incision. There was no significant difference in postoperative complications between the two procedures.