深层巩膜切除术联合植入物治疗开角型青光眼的系统综述

目的：系统评价深层巩膜切除术联合不同植入物治疗开角型青光眼的疗效。方法：检索MEDLINE，获得11篇以往发表的论文，根据临床和统计标准进行综合分析，比较胶原，Healon GV,SK,Gel3种植入物的降压效果，结果：总共有11面临床研究的864例（997眼）患者纳入系统综述，术后眼内压均有明显的下降，无辅助降眼压药物的治疗成功率分别为：胶原61．7％，HealonGV73.0%,SK Gel67.6%，而单纯深层巩膜切除术仅为51．1％（P＜0．05）；辅助降眼压药物的治疗成功率分别为：92．0％、86．7％、90．2％，而单纯深层巩膜切除术仅为71．6％（P＜0．001）。治疗并发症分别为：胶原38．8％、Healon GV32.6%,SK Gel20.6%。结论：三种植入物（胶原、Healon GV,SK Gel）联合深层巩膜切除术治疗开角型青光眼的疗效显著。比单纯深层巩膜切除术的成功率高，SK Gel的并发症少，可能是治疗开角型青光眼的较好的植入物。

Systemic Overview of Deep Sclerectomy with implant in Open-angle Glaucoma

Objective To assess the efficacy and safety of deep sclerectomy with different implant in open-angle glaucoma. Methods Data from 11 relevant studies were retrieved by means of computerized search, The combinabiltity of the studies was assessed in terms of clinical and statistical criteria, and we compared the efficacy of collagen implant ,Healon GV and SK Gel on intraocular pressure (IOP). Results A total of 864 palicnts(997 eyes)were included in 11 trials. The means postoperative IOP were similar and decreased. The success rate without medical therapy was:collagen implant 61. 7%,Healon GV 73. 0%,and SK Gel 67.6% respectively, and there were significant difference compared with deep sclerectomy single (51.1%). The success rate with medical therapy was 92. 0%, 86. 7% , and 90.2% respectively, and the same was significant difference compared with deep sclerectomy single (76. 7%). The complications rate was 38. 8%, 32. 6% , and 20.6% respectively. Conclusion Deep sclerectomy with three implant (collagen implant,Healon GV,SK Gel)can be considered as an excellent alternative to deep sclerectomy single in open-angle glaucoma. The complications rate of SK Gel is less and may be better implant.