Guoji Yanke Zazhi (Sep 2015)
Comparison between two surgeries for angle-closure glaucoma combined with cataract: a Meta-analysis
Abstract
AIM:To evaluate the comparative effectiveness between phacoemulsification cataract extraction combined with either goniosynechialysis or trabeculectomy for the treatment of primary angle-closure glaucoma with cataract.METHODS: We searched literatures about randomized controlled trial(RCT)in phacoemulsification cataract extraction combined with goniosynechialysis compare with phacoemulsification cataract extraction combined with trabeculectomy for treatment of primary angle-closure glaucoma, in database of PubMed, Science Direct, CNKI, CqVip and Wanf, collected from January 2000 to February 2015, published or embodied. Clinical evaluation included amplitude of intraocular pressure(IOP)variation, vision improvement, anterior chamber depth change, angle open degree, success rate and postoperative complications. Revman5.0 Meta analysis software was used.RESULTS: According to the literature and exclusion criteria, finally 5 references were included in the Meta analysis, with a total of 492 patients. Meta analysis results showed that reduction of IOP in phacoemulsification cataract extraction combined with trabeculectomy was larger \; with goniosynechialysis, angle open degree was better, as well as the anterior chamber depth \; in vision improvement and success rate, there was no significant difference \〖OR 0.39, 95% CI(0.12～1.30)\〗; with trabeculectomy, there existed more complications.CONCLUSION: Phacoemulsification cataract extraction combined with either goniosynechialysis or trabeculectomy can effectively control intraocular pressure and improve visual acuity. With goniosynechialysis, because of its fewer complications, it has the potential to be one of the main treatments in treating primary angle-closure glaucoma with cataract.
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