AIM:To compare the clinical efficacy and safety of non-penetrating glaucoma surgery(NPGS)plus phacoemulsification(Phaco-NPGS)and NPGS-alone.METHODS:We systematically searched various databases and reviewed studies tha...AIM:To compare the clinical efficacy and safety of non-penetrating glaucoma surgery(NPGS)plus phacoemulsification(Phaco-NPGS)and NPGS-alone.METHODS:We systematically searched various databases and reviewed studies that had evaluated the effects of Phaco-NPGS or NPGS-alone for patients with glaucoma.Primary outcomes included postoperative intraocular pressure(IOP)and the number of postoperative antiglaucoma medications.Secondary outcomes were the prevalence of complications,incidence of needling or goniopuncture,and surgical success rate.RESULTS:In total,380 and 424 eyes in NPGS-alone and Phaco-NPGS groups respectively were included.Both postoperative IOP and number of medications were significantly lowered in the Phaco-NPGS group than that in the NPDS-alone group[weighted mean difference(WMD)=-1.12,95%confidence interval(CI):-2.11 to-0.12,P=0.03;WMD=-0.31,95%CI:-0.53 to-0.09,P=0.006].Moreover,Phaco-NPGS had a significantly lower prevalence of complications and postoperative procedures compared to NPGS-alone,while no significant difference existed for surgical success.CONCLUSION:Phaco-NPGS superior to NPGS-alone in the reduction of IOP and medications.Phaco-NPGS can be recommended for glaucoma patients with coexisting cataracts owing to its superior efficacy,fewer complications,and postoperative procedures.展开更多
AIM： To conduct a systematic review and quantitative Meta-analysis of the efficacy and safety of combined surgery for the eyes with coexisting cataract and open angle glaucoma.METHODS： We performed a systematic sear...AIM： To conduct a systematic review and quantitative Meta-analysis of the efficacy and safety of combined surgery for the eyes with coexisting cataract and open angle glaucoma.METHODS： We performed a systematic search of the related literature in the Cochrane Library, PubM ed, EMBASE, Web of Science databases, CNKI, CBM and Wan Fang databases, with no limitations on language or publication date. The primary efficacy estimate was identified by weighted mean difference of the percentage of intraocular pressure reduction（IOPR%） from baseline to end-point, the percentage of number of glaucoma medications reduction from pre-to post-operation, and the secondary efficacy evaluations were performed by odds ratio（OR） and 95% confidence interval（CI） for complete and qualified success rate. Besides, ORs were applied to assess the tolerability of adverse incidents. Meta-analyses of fixed or random effect models were performed using Rev Man software 5.2 to gather the consequences. Heterogeneity was evaluated by Chi^2 test and the I^2 measure.RESULTS： Ten studies enrolling 3108 patients were included. The combined consequences indicated that both glaucoma and combined cataract and glaucoma surgery significantly decreased IOP. For deep sclerectomy vs deep sclerectomy plus phacoemulsification and canaloplasty vs phaco-canaloplasty, the differences in IOPR% were not all statistically significant while trabeculotomy was detected to gain a quantitatively greater IOPR% compared with trabeculotomy plus phacoemulsification. Furthermore, there was no statistical significance in the complete and qualified success rate, and the rates of adverse incidents for trabeculotomy vs trabeculotomy plus phacoemulsification.CONCLUSION： Compared with trabeculotomy plus phacoemulsification, trabeculectomy alone is more effective in lowering IOP and the number of glaucoma medications, while the two surgeries can not demonstrate statistical differences in the complete success rate, qualified success rate, or incidence of adverse incidents.展开更多
AIM： To compare the long-term outcomes of the Ex-PRESS miniature glaucoma device implanted under a scleral flap in combination of phacoemulsification with intraocular lens implantation in primary open angle glaucoma ...AIM： To compare the long-term outcomes of the Ex-PRESS miniature glaucoma device implanted under a scleral flap in combination of phacoemulsification with intraocular lens implantation in primary open angle glaucoma （POAG） and chronic primary angle-closure glaucoma （CPACG）.METHODS： Retrospective, comparative study. A total of 60 eyes （60 patients） receiving the Ex-PRESS miniature glaucoma device implantation combined with phacoemulsification were reviewed. Thirty eyes （30 patients） had the combined procedures for POAG, and the other 30 eyes （30 patients） for CPACG. RESULTS： The follow-up was 39.37±7.09mo （range 3 to 49mo） in patients with POAG and 37.10±9.26mo （range 9 to 49mo） in patients with CPACG （P=0.29）. The mean change in best corrected visual acuity was 0.41 logMAR for POAG and 0.38 logMAR for CPACG at the last follow-up （P=0.22）. The postoperative intraocular pressure （IOP） of the POAG group was significantly lower than the CPACG group at 1, 3, 12, and 18mo after surgery （P=0.02, 0.00, 0.04, 0.01） with similar glaucoma medications after surgery （P〉0.16）. At 3y after surgery, the cumulative complete and qualified success rates were 63.3% （POAG） and 53.3% （CPACG）, 83.3% （POAG） and 73.3% （CPACG） （P=0.41, 0.49）, respectively. The POAG group had more hypotony than the CPACG group （P=0.04）.CONCLUSION： The long-term outcomes show the Ex-PRESS implantation combined with phacoemulcification can effectively lower the IOP in both the POAG and CPACG groups. The POAG group seems to have lower postoperative IOP and a higher risk of hypotony.展开更多
目的探讨研究马斯洛需要层次理论下全面护理对白内障超声乳化手术患者的影响。方法前瞻性随机选取2021年1月—2023年1月北京航天总医院收治的400例行白内障超声乳化手术患者为研究对象,依据不同护理方法分为对照组(n=200)和观察组(n=200...目的探讨研究马斯洛需要层次理论下全面护理对白内障超声乳化手术患者的影响。方法前瞻性随机选取2021年1月—2023年1月北京航天总医院收治的400例行白内障超声乳化手术患者为研究对象,依据不同护理方法分为对照组(n=200)和观察组(n=200)。对照组给予常规围术期护理,观察组予以马斯洛需要层次理论下全面护理。对比两组心理状态[采用抑郁自评量表(Self-rating Depression Scale,SDS)、焦虑自评量表(Self-rating Anxiety Scale,SAS)评估]、低视力生活质量(Low Vision Quality of Life Questionnaire,LVQOL)、认知情况评分、并发症发生率。结果干预后,观察组SAS、SDS评分均低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组远视力、移动、光感、调节功能、读与精细工作、日常生活评分均优于对照组,差异有统计学意义(P均<0.05)。干预后,观察组疾病掌握、手术了解、预后认知评分均高于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率为5.50%(11/200)低于对照组的11.00%(22/200),差异有统计学意义(χ^(2)=3.996,P<0.05)。结论马斯洛需要层次理论下全面护理在白内障超声乳化手术中应用可改善患者的心理状态与疾病认知水平,对视力提升起到更好的预后效果,有利于降低术后并发症的发生,具有较好的临床研究价值。展开更多
文摘AIM:To compare the clinical efficacy and safety of non-penetrating glaucoma surgery(NPGS)plus phacoemulsification(Phaco-NPGS)and NPGS-alone.METHODS:We systematically searched various databases and reviewed studies that had evaluated the effects of Phaco-NPGS or NPGS-alone for patients with glaucoma.Primary outcomes included postoperative intraocular pressure(IOP)and the number of postoperative antiglaucoma medications.Secondary outcomes were the prevalence of complications,incidence of needling or goniopuncture,and surgical success rate.RESULTS:In total,380 and 424 eyes in NPGS-alone and Phaco-NPGS groups respectively were included.Both postoperative IOP and number of medications were significantly lowered in the Phaco-NPGS group than that in the NPDS-alone group[weighted mean difference(WMD)=-1.12,95%confidence interval(CI):-2.11 to-0.12,P=0.03;WMD=-0.31,95%CI:-0.53 to-0.09,P=0.006].Moreover,Phaco-NPGS had a significantly lower prevalence of complications and postoperative procedures compared to NPGS-alone,while no significant difference existed for surgical success.CONCLUSION:Phaco-NPGS superior to NPGS-alone in the reduction of IOP and medications.Phaco-NPGS can be recommended for glaucoma patients with coexisting cataracts owing to its superior efficacy,fewer complications,and postoperative procedures.
基金Supported by National Natural Science Foundation of China(No.8170080No.81470609)the Natural Science Foundation of Shandong Province(No.ZR2017MH008)
文摘AIM： To conduct a systematic review and quantitative Meta-analysis of the efficacy and safety of combined surgery for the eyes with coexisting cataract and open angle glaucoma.METHODS： We performed a systematic search of the related literature in the Cochrane Library, PubM ed, EMBASE, Web of Science databases, CNKI, CBM and Wan Fang databases, with no limitations on language or publication date. The primary efficacy estimate was identified by weighted mean difference of the percentage of intraocular pressure reduction（IOPR%） from baseline to end-point, the percentage of number of glaucoma medications reduction from pre-to post-operation, and the secondary efficacy evaluations were performed by odds ratio（OR） and 95% confidence interval（CI） for complete and qualified success rate. Besides, ORs were applied to assess the tolerability of adverse incidents. Meta-analyses of fixed or random effect models were performed using Rev Man software 5.2 to gather the consequences. Heterogeneity was evaluated by Chi^2 test and the I^2 measure.RESULTS： Ten studies enrolling 3108 patients were included. The combined consequences indicated that both glaucoma and combined cataract and glaucoma surgery significantly decreased IOP. For deep sclerectomy vs deep sclerectomy plus phacoemulsification and canaloplasty vs phaco-canaloplasty, the differences in IOPR% were not all statistically significant while trabeculotomy was detected to gain a quantitatively greater IOPR% compared with trabeculotomy plus phacoemulsification. Furthermore, there was no statistical significance in the complete and qualified success rate, and the rates of adverse incidents for trabeculotomy vs trabeculotomy plus phacoemulsification.CONCLUSION： Compared with trabeculotomy plus phacoemulsification, trabeculectomy alone is more effective in lowering IOP and the number of glaucoma medications, while the two surgeries can not demonstrate statistical differences in the complete success rate, qualified success rate, or incidence of adverse incidents.
基金Supported by the Key Laboratory Program of Shandong Eye Institute(No.2014-1)Medicine Science and Technology Development Program,Shandong,China(No.2015WS0204)+1 种基金the Science and Technology plan of Qingdao,China(No.15-9-1-35-jch)the Innovation Project of Shandong Academy of Medical Sciences
文摘AIM： To compare the long-term outcomes of the Ex-PRESS miniature glaucoma device implanted under a scleral flap in combination of phacoemulsification with intraocular lens implantation in primary open angle glaucoma （POAG） and chronic primary angle-closure glaucoma （CPACG）.METHODS： Retrospective, comparative study. A total of 60 eyes （60 patients） receiving the Ex-PRESS miniature glaucoma device implantation combined with phacoemulsification were reviewed. Thirty eyes （30 patients） had the combined procedures for POAG, and the other 30 eyes （30 patients） for CPACG. RESULTS： The follow-up was 39.37±7.09mo （range 3 to 49mo） in patients with POAG and 37.10±9.26mo （range 9 to 49mo） in patients with CPACG （P=0.29）. The mean change in best corrected visual acuity was 0.41 logMAR for POAG and 0.38 logMAR for CPACG at the last follow-up （P=0.22）. The postoperative intraocular pressure （IOP） of the POAG group was significantly lower than the CPACG group at 1, 3, 12, and 18mo after surgery （P=0.02, 0.00, 0.04, 0.01） with similar glaucoma medications after surgery （P〉0.16）. At 3y after surgery, the cumulative complete and qualified success rates were 63.3% （POAG） and 53.3% （CPACG）, 83.3% （POAG） and 73.3% （CPACG） （P=0.41, 0.49）, respectively. The POAG group had more hypotony than the CPACG group （P=0.04）.CONCLUSION： The long-term outcomes show the Ex-PRESS implantation combined with phacoemulcification can effectively lower the IOP in both the POAG and CPACG groups. The POAG group seems to have lower postoperative IOP and a higher risk of hypotony.
文摘目的探讨研究马斯洛需要层次理论下全面护理对白内障超声乳化手术患者的影响。方法前瞻性随机选取2021年1月—2023年1月北京航天总医院收治的400例行白内障超声乳化手术患者为研究对象,依据不同护理方法分为对照组(n=200)和观察组(n=200)。对照组给予常规围术期护理,观察组予以马斯洛需要层次理论下全面护理。对比两组心理状态[采用抑郁自评量表(Self-rating Depression Scale,SDS)、焦虑自评量表(Self-rating Anxiety Scale,SAS)评估]、低视力生活质量(Low Vision Quality of Life Questionnaire,LVQOL)、认知情况评分、并发症发生率。结果干预后,观察组SAS、SDS评分均低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组远视力、移动、光感、调节功能、读与精细工作、日常生活评分均优于对照组,差异有统计学意义(P均<0.05)。干预后,观察组疾病掌握、手术了解、预后认知评分均高于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率为5.50%(11/200)低于对照组的11.00%(22/200),差异有统计学意义(χ^(2)=3.996,P<0.05)。结论马斯洛需要层次理论下全面护理在白内障超声乳化手术中应用可改善患者的心理状态与疾病认知水平,对视力提升起到更好的预后效果,有利于降低术后并发症的发生,具有较好的临床研究价值。
