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 evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS~ P-50 for combined cataract surgery and glaucoma.·METHODS： Patients having cataract and open angle glaucoma or patients with open ad...AIM： To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS~ P-50 for combined cataract surgery and glaucoma.·METHODS： Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS~ P-50 model placed under scleral flap was performed.·RESULTS： Out of 40 eyes of 40 patients（55% male and45% female） completed the study during one-year follow-up. The mean of age was 76.6 ±11.02 y. The intraocular pressure（IOP） decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg（Wilcoxon signed ranks test, P 〈0.001）. A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control（〈21 mm Hg）.·CONCLUSION：Combinedsurgeryofphacoemulsification with Ex PRESS~ P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation.展开更多
AIM:To investigate the efficacy and safety of combined phacoemulsification and goniosynechialysis with or without endoscopic cyclophotocoagulation(PGE group and PG group)for the treatment of patients with coexisting p...AIM:To investigate the efficacy and safety of combined phacoemulsification and goniosynechialysis with or without endoscopic cyclophotocoagulation(PGE group and PG group)for the treatment of patients with coexisting primary angle-closure glaucoma(PACG)and cataracts.METHODS:The clinical data of patients with PACG and cataract were retrospectively reviewed.There was a total of 88 eyes in the study and were divided into two groups,42 eyes in PGE group and 46 eyes in PG group.Surgery success cumulative survival,preoperative and postoperative intraocular pressure(IOP),number of IOPlowering medications,best corrected visual acuity(BCVA)in the two groups were observed for more than 12 mo and compared within each group and between two groups.RESULTS:The mean IOP in PGE group declined from24.9 mm Hg preoperatively to 14.1 mm Hg at the first month after operation(P<0.001)and at the last visit 16.2 mm Hg(P<0.001).Meanwhile PG group also showed significant decrease,from 24.1 mm Hg preoperatively to 13.0 mm Hg at Imo after operation(P<0.001)and 15.3 mm Hg at the last visit(P=0.004).The mean medications reliance reduced in both groups,in PGE group was reduced from 1.62 preoperatively to 0.13 at the last visit(P<0.001),in PG group from 0.87 to 0.10(P<0.001).At the last visit,BCVA increased from 0.21 to 0.60 in PGE group(P<0.001)and from 0.24 to 0.67 in PG group(P<0.001).The success rate of PGE group at 1 mo was95.2%,then decreased to 70.7%at the last visit,whereas in PG group,the success rate at 1 mo was 100%,at the last visit was 73.4%.CONCLUSION:PGE shows promise for PACG patients with cataracts to reduce IOP,lighten the medication burden and improve visual acuity,and PG still has its value in specific patients.展开更多
目的探讨眼压对青光眼—白内障联合术患者人工晶状体计算公式选择的影响,为临床上避免屈光误差(refractive error,RE)提供参考依据。方法选取2014年5月至2017年4月在我院行白内障超声乳化吸出并人工晶状体植入联合复合式小梁切除术的原...目的探讨眼压对青光眼—白内障联合术患者人工晶状体计算公式选择的影响,为临床上避免屈光误差(refractive error,RE)提供参考依据。方法选取2014年5月至2017年4月在我院行白内障超声乳化吸出并人工晶状体植入联合复合式小梁切除术的原发性闭角型青光眼(primary angle-closure glaucoma,PACG)合并白内障患者72例(80眼),依术前平均眼压将测试眼分为两组:正常眼压组(10~21 mm Hg,1 k Pa=7.5 mm Hg)和高眼压组(>21 mm Hg),分别为28眼和52眼。比较各组内术后3个月验光所得实际等效球镜度与术前人工晶状体Master中4种人工晶状体计算公式(SRK/T、Holladay1、Hoffer Q及Haigis)相应预测等效球镜度的差异。定义实际等效球镜度减去预测等效球镜度即为RE,当RE<0时为屈光近视漂移,而RE>0则为屈光远视漂移,RE取绝对值为绝对屈光误差(absolute refractive error,ARE),评估眼压对各公式术后ARE及RE的影响。术后随访6个月。结果全部患者术后3个月眼压较术前下降明显,差异有统计学意义(t=9.96,P=0.000),且眼压降低幅度与术前平均眼压呈正相关(r=0.974,P=0.000)。正常眼压组SRK/T、Holladay1、Hoffer Q、Haigis公式ARE的中位数差异有统计学意义(P=0.008);高眼压组各公式ARE的中位数差异亦有统计学意义(P=0.004)。正常眼压组和高眼压组远视漂移时SRK/T、Holladay1、Hoffer Q、Haigis公式RE总体差异均无统计学意义(P=0.633、0.422)。正常眼压组近视漂移时各公式RE间总体差异有统计学意义(P=0.000),经LSD两两比较,SRK/T公式较其他公式的RE小(均为P<0.01),Haigis公式较其他公式的RE大(均为P<0.05),其他各公式RE差异均无统计学意义(均为P>0.05)。而高眼压组近视漂移时各公式RE总体差异亦有统计学意义(F=6.757,P=0.000),经LSD两两比较,Hoffer Q公式RE较其他公式的小(均为P<0.01),其他各公式RE差异均无统计学意义(均为P>0.05)。结论青光眼—白内障联合术可提高患者视力并改善眼压,术后眼压降低幅度与术前平均眼压呈明显正相关。计算青光眼—白内障联合术人工晶状体度数时,术前平均眼压正常者应选SRK/T公式较为准确,而术前平均眼压高时Hoffer Q公式更合适。展开更多
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.
文摘AIM： To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS~ P-50 for combined cataract surgery and glaucoma.·METHODS： Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS~ P-50 model placed under scleral flap was performed.·RESULTS： Out of 40 eyes of 40 patients（55% male and45% female） completed the study during one-year follow-up. The mean of age was 76.6 ±11.02 y. The intraocular pressure（IOP） decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg（Wilcoxon signed ranks test, P 〈0.001）. A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control（〈21 mm Hg）.·CONCLUSION：Combinedsurgeryofphacoemulsification with Ex PRESS~ P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation.
文摘AIM:To investigate the efficacy and safety of combined phacoemulsification and goniosynechialysis with or without endoscopic cyclophotocoagulation(PGE group and PG group)for the treatment of patients with coexisting primary angle-closure glaucoma(PACG)and cataracts.METHODS:The clinical data of patients with PACG and cataract were retrospectively reviewed.There was a total of 88 eyes in the study and were divided into two groups,42 eyes in PGE group and 46 eyes in PG group.Surgery success cumulative survival,preoperative and postoperative intraocular pressure(IOP),number of IOPlowering medications,best corrected visual acuity(BCVA)in the two groups were observed for more than 12 mo and compared within each group and between two groups.RESULTS:The mean IOP in PGE group declined from24.9 mm Hg preoperatively to 14.1 mm Hg at the first month after operation(P<0.001)and at the last visit 16.2 mm Hg(P<0.001).Meanwhile PG group also showed significant decrease,from 24.1 mm Hg preoperatively to 13.0 mm Hg at Imo after operation(P<0.001)and 15.3 mm Hg at the last visit(P=0.004).The mean medications reliance reduced in both groups,in PGE group was reduced from 1.62 preoperatively to 0.13 at the last visit(P<0.001),in PG group from 0.87 to 0.10(P<0.001).At the last visit,BCVA increased from 0.21 to 0.60 in PGE group(P<0.001)and from 0.24 to 0.67 in PG group(P<0.001).The success rate of PGE group at 1 mo was95.2%,then decreased to 70.7%at the last visit,whereas in PG group,the success rate at 1 mo was 100%,at the last visit was 73.4%.CONCLUSION:PGE shows promise for PACG patients with cataracts to reduce IOP,lighten the medication burden and improve visual acuity,and PG still has its value in specific patients.
文摘目的探讨眼压对青光眼—白内障联合术患者人工晶状体计算公式选择的影响,为临床上避免屈光误差(refractive error,RE)提供参考依据。方法选取2014年5月至2017年4月在我院行白内障超声乳化吸出并人工晶状体植入联合复合式小梁切除术的原发性闭角型青光眼(primary angle-closure glaucoma,PACG)合并白内障患者72例(80眼),依术前平均眼压将测试眼分为两组:正常眼压组(10~21 mm Hg,1 k Pa=7.5 mm Hg)和高眼压组(>21 mm Hg),分别为28眼和52眼。比较各组内术后3个月验光所得实际等效球镜度与术前人工晶状体Master中4种人工晶状体计算公式(SRK/T、Holladay1、Hoffer Q及Haigis)相应预测等效球镜度的差异。定义实际等效球镜度减去预测等效球镜度即为RE,当RE<0时为屈光近视漂移,而RE>0则为屈光远视漂移,RE取绝对值为绝对屈光误差(absolute refractive error,ARE),评估眼压对各公式术后ARE及RE的影响。术后随访6个月。结果全部患者术后3个月眼压较术前下降明显,差异有统计学意义(t=9.96,P=0.000),且眼压降低幅度与术前平均眼压呈正相关(r=0.974,P=0.000)。正常眼压组SRK/T、Holladay1、Hoffer Q、Haigis公式ARE的中位数差异有统计学意义(P=0.008);高眼压组各公式ARE的中位数差异亦有统计学意义(P=0.004)。正常眼压组和高眼压组远视漂移时SRK/T、Holladay1、Hoffer Q、Haigis公式RE总体差异均无统计学意义(P=0.633、0.422)。正常眼压组近视漂移时各公式RE间总体差异有统计学意义(P=0.000),经LSD两两比较,SRK/T公式较其他公式的RE小(均为P<0.01),Haigis公式较其他公式的RE大(均为P<0.05),其他各公式RE差异均无统计学意义(均为P>0.05)。而高眼压组近视漂移时各公式RE总体差异亦有统计学意义(F=6.757,P=0.000),经LSD两两比较,Hoffer Q公式RE较其他公式的小(均为P<0.01),其他各公式RE差异均无统计学意义(均为P>0.05)。结论青光眼—白内障联合术可提高患者视力并改善眼压,术后眼压降低幅度与术前平均眼压呈明显正相关。计算青光眼—白内障联合术人工晶状体度数时,术前平均眼压正常者应选SRK/T公式较为准确,而术前平均眼压高时Hoffer Q公式更合适。
