摘要
Background Phacotrabeculectomy can be performed using one-site or two-site incisions.This meta-analysis evaluated the efficacy and tolerability of one-site versus two-site phacotrabecuiectomy in the treatment of patients with coexisting cataract and glaucoma.Methods A comprehensive literature search was performed according to the Cochrane Collaboration methodology toidentify randomized controlled clinical trials comparing one-site with two-site phacotrabeculectomy.Studies meeting our predefined criteria were included in the meta-analysis.Efficacy estimates were measured by weighted mean difference （WMD） for the percentage intraocular pressure （IOP） reduction from baseline to end point, relative risk （RR） for the proportion of patients with a best-corrected visual acuity （BCVA） of 0.5 or better after surgery and complete success rates.Tolerability estimates were measured by RR for adverse events.All of outcomes were reported with 95% confidence interval （95% CI）.Data were synthesised by Stata 10.1 for Windows.Results Two-site phacotrabeculectomy was associated with greater reductions in IOP than the one-site procedure （WMD： -5.99, 95% CI： -10.74-1.24, P=0.01）.A greater proportion of patients also achieved a BCVA of 0.5 or better （RR：0.91, 95% CI： 0.74-1.12, P=0.36） and the target IOP without anti-glaucoma medication at the study end point （RR： 0.94,95% CI： 0.83-1.07, P=0.34） after two-site than one-site phacotrabeculectomy, but the differences were not significant.There were no significant differences in adverse events between two surgical procedures.Conclusions Two-site phacotrabeculectomy is superior to one-site phacotrabeculectomy in reducing IOP, but other post-operative effects are similar.One-site and two-site phacotrabeculectomies have similar adverse event rates.
Background Phacotrabeculectomy can be performed using one-site or two-site incisions.This meta-analysis evaluated the efficacy and tolerability of one-site versus two-site phacotrabecuiectomy in the treatment of patients with coexisting cataract and glaucoma.Methods A comprehensive literature search was performed according to the Cochrane Collaboration methodology toidentify randomized controlled clinical trials comparing one-site with two-site phacotrabeculectomy.Studies meeting our predefined criteria were included in the meta-analysis.Efficacy estimates were measured by weighted mean difference （WMD） for the percentage intraocular pressure （IOP） reduction from baseline to end point, relative risk （RR） for the proportion of patients with a best-corrected visual acuity （BCVA） of 0.5 or better after surgery and complete success rates.Tolerability estimates were measured by RR for adverse events.All of outcomes were reported with 95% confidence interval （95% CI）.Data were synthesised by Stata 10.1 for Windows.Results Two-site phacotrabeculectomy was associated with greater reductions in IOP than the one-site procedure （WMD： -5.99, 95% CI： -10.74-1.24, P=0.01）.A greater proportion of patients also achieved a BCVA of 0.5 or better （RR：0.91, 95% CI： 0.74-1.12, P=0.36） and the target IOP without anti-glaucoma medication at the study end point （RR： 0.94,95% CI： 0.83-1.07, P=0.34） after two-site than one-site phacotrabeculectomy, but the differences were not significant.There were no significant differences in adverse events between two surgical procedures.Conclusions Two-site phacotrabeculectomy is superior to one-site phacotrabeculectomy in reducing IOP, but other post-operative effects are similar.One-site and two-site phacotrabeculectomies have similar adverse event rates.
