Non-penetrating Trabecular Surgery versus Trabeculectomy for Open Aangle Glaucoma: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

MinawaerAbudu ¹ , JuretKadir ¹ , MamatjanAbudukadir ² , CHEN Xueyi ¹ , Junire ³ , AkramArkin ¹

1. Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;2. Evidence-Based Medicine Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;3. The First School of Clinical Sciences, Xinjiang Medical University, Urumqi 830054, China;

Corresponding author：

Keywords：

Non-penetrating trabecular surgery; Trabeculectomy; Open angle glaucoma; Effectiveness assessment; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.20080239

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Objectives 　To assess the clinical effectiveness of non-penetrating trabecular surgery versus trabeculectomy for open angle glaucoma.
Methods 　We searched the Cochrane Central Register of Controlled Trials (issue 2, 2007), MEDLINE (1966 to May 2008), EMbase (1980 to May 2008), and CMB-disk (1979 to May 2008). We also hand searched relevant journals and conference proceedings. Data were extracted by two reviewers independently using an extraction form. The Cochrane Collaboration’s RevMan 5.0 software was used for statistical analysis.
Results 　Three RCTs involving 127 participants (144 eyes) with previously untreated open angle glaucoma were included. Meta-analysis showed that compared with non-penetrating trabecular surgery, trabeculectomy increased the proportion of patients with reduced postoperative intraocular pressure (WMD2.78, 95%CI 1.41 to 4.15), improved the operation success rate (RR 0.53, 95%CI 0.37 to 0.77), and reduced the use of postoperative antiglaucoma medication (WMD 0.96, 95%CI 0.84 to 1.08). Non-penetrating trabecular surgery reduced the incidence of postoperative complications (RR 17.00, 95%CI 8.36 to 26.00).
Conclusion 　 Since the sample sizes of the included trials are relatively small, and the two procedures are also related to progressive visual field loss and optic disk damage, more well-designed large-scale RCTs are required.

Citation： MinawaerAbudu,JuretKadir,MamatjanAbudukadir,CHEN Xueyi,Junire,AkramArkin. Non-penetrating Trabecular Surgery versus Trabeculectomy for Open Aangle Glaucoma: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(12): 1094-1099. doi: 10.7507/1672-2531.20080239 Copy

1.	Burr J, Azuara-Blanco A, Avenell A. Medical versus surgical interventions for open angle glaucoma. Cochrane Database Syst Rev, 2005 Apr 18, (2): CD004399.
2.	李美玉. 主编. 青光眼学. 第1版. 北京: 人民卫生出版社. 2004, 前言, 587.
3.	Law SK, Li T. Acupuncture for glaucoma. Cochrane Database Syst Rev, 2007 Oct 17, (4): CD006030, DOI: 10.1002/14651858.
4.	Rolim de Moura C, Paranhos Jr A, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database Syst Rev, 2007 Oct 17, (4): CD003919.
5.	Cairns JE. Trabeculectomy: Preliminary report of a new method. Am J Ophthalmol, 1968, 66(4): 673-679.
6.	Yalvac IS, Sahin M, Eksioglu U, et al. Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma: three-year prospective randomized clinical trial. J Cataract Refract Surg, 2004, 30(10): 2050-2057.
7.	艾华, 杨新光, 王润生, 等. 非穿透小梁手术和小梁切除手术治疗开角型青光眼临床效果比较. 国际眼科杂志, 2006, 6(5): 1072-1074.
8.	郭燕, 夏晓波, 江海波, 等. 非穿透性小梁手术联合透明质酸钠生物胶植入术治疗开角型青光眼. 国际眼科杂志, 2006, 6(1): 92-96.
9.	Lüke C, Dietlein T S, Jacobi P C, et al. A prospective randomized trial of viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study. J Glaucoma, 2002, 11(4): 294-299.
10.	Gilmour1 DF, Manners TD, Devonport H, et al. Viscocanalostomy versus trabeculectomy for primary open angle glaucoma: 4-year prospective randomized clinical trial. Eye, 2007, [Epub ahead of print].
11.	Chi s e l i ta D. Non-pene t rat ing de ep s c l e r e c tomy ve r sus trabeculectomy in primary open-angle glaucoma surgery. Eye, 2001, 15(Pt 2): 197-201.
12.	Zimmerm TJ, Kooner KS, Ford VJ, et al. Trabeculectomy vs nonpenetrating trabeculectomy:a retrospective study of two procedures in phakic patients withglaucoma. O phthalm ic Surg, 1984, 15(9): 34-740.
13.	Stegmanm R, Pienaar A, Miller D. Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg, 1999, 25(3): 316-322.
14.	Shaarawy T, Nguyen C, Schnyder C. A Mermoud Five year results of viscocanalostomy. Eur J Ophthalmol, 2008, 18(3): 417-422.
15.	Lüke C, Dietlein TS, Jacobi PC, et al. A prospective randomised trial of viscocanalostomy with and without implantation of a reticulated hyaluronic acid implant(SKGEL)in open angle glaucoma. Br J Ophthalmol, 2003, 87(5): 599-603.
16.	李美玉. 非穿透性小梁手术联合透明质酸钠生物胶植入术的临床疗效观察. 中华眼科学杂志, 2001, 37(6): 404-408.
17.	Yarangümeli A, Güreser S, Köz OG, et al. Viscocanalostomy versus trabeculectomy in patients with bilateral high-tension glaucoma. Int Ophthalmol, 2004, 25(4): 207-213.
18.	Mermoud A, Schnyder CC, Michel E, et al. Comparison of deep sclerectomy with collagen implant and trabeculectomy in openangle. J Cataract Refract Surg, 1999, 25(3): 323-331.
19.	王宁利, 吴河坪, 叶天才. 非穿透小梁手术中术后早中期并发症疗效分析. 中华眼科杂志, 2002, 38(6): 329-334.
20.	王宁利, 梁远波, 庄雪梅, 等. 非穿透性手术的术后早期并发症及成本效果分析. 中华眼科学杂志, 2005, 41(6): 505-510.
21.	霍鸣, 李娟, 张海江, 等. 非穿透性与改良手术治疗开角型青光眼的远期疗效. 国际眼科学杂志, 2008, 8(2): 396-397.
22.	黄燕, 王宁利, 王班伟, 等. 非穿透性小梁手术治疗原发性开角型青光眼的远期疗效. 眼科学杂志, 2006, 15(14): 277-280.

1. Burr J, Azuara-Blanco A, Avenell A. Medical versus surgical interventions for open angle glaucoma. Cochrane Database Syst Rev, 2005 Apr 18, (2): CD004399.
2. 李美玉. 主编. 青光眼学. 第1版. 北京: 人民卫生出版社. 2004, 前言, 587.
3. Law SK, Li T. Acupuncture for glaucoma. Cochrane Database Syst Rev, 2007 Oct 17, (4): CD006030, DOI: 10.1002/14651858.
4. Rolim de Moura C, Paranhos Jr A, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database Syst Rev, 2007 Oct 17, (4): CD003919.
5. Cairns JE. Trabeculectomy: Preliminary report of a new method. Am J Ophthalmol, 1968, 66(4): 673-679.
6. Yalvac IS, Sahin M, Eksioglu U, et al. Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma: three-year prospective randomized clinical trial. J Cataract Refract Surg, 2004, 30(10): 2050-2057.
7. 艾华, 杨新光, 王润生, 等. 非穿透小梁手术和小梁切除手术治疗开角型青光眼临床效果比较. 国际眼科杂志, 2006, 6(5): 1072-1074.
8. 郭燕, 夏晓波, 江海波, 等. 非穿透性小梁手术联合透明质酸钠生物胶植入术治疗开角型青光眼. 国际眼科杂志, 2006, 6(1): 92-96.
9. Lüke C, Dietlein T S, Jacobi P C, et al. A prospective randomized trial of viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study. J Glaucoma, 2002, 11(4): 294-299.
10. Gilmour1 DF, Manners TD, Devonport H, et al. Viscocanalostomy versus trabeculectomy for primary open angle glaucoma: 4-year prospective randomized clinical trial. Eye, 2007, [Epub ahead of print].
11. Chi s e l i ta D. Non-pene t rat ing de ep s c l e r e c tomy ve r sus trabeculectomy in primary open-angle glaucoma surgery. Eye, 2001, 15(Pt 2): 197-201.
12. Zimmerm TJ, Kooner KS, Ford VJ, et al. Trabeculectomy vs nonpenetrating trabeculectomy:a retrospective study of two procedures in phakic patients withglaucoma. O phthalm ic Surg, 1984, 15(9): 34-740.
13. Stegmanm R, Pienaar A, Miller D. Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg, 1999, 25(3): 316-322.
14. Shaarawy T, Nguyen C, Schnyder C. A Mermoud Five year results of viscocanalostomy. Eur J Ophthalmol, 2008, 18(3): 417-422.
15. Lüke C, Dietlein TS, Jacobi PC, et al. A prospective randomised trial of viscocanalostomy with and without implantation of a reticulated hyaluronic acid implant(SKGEL)in open angle glaucoma. Br J Ophthalmol, 2003, 87(5): 599-603.
16. 李美玉. 非穿透性小梁手术联合透明质酸钠生物胶植入术的临床疗效观察. 中华眼科学杂志, 2001, 37(6): 404-408.
17. Yarangümeli A, Güreser S, Köz OG, et al. Viscocanalostomy versus trabeculectomy in patients with bilateral high-tension glaucoma. Int Ophthalmol, 2004, 25(4): 207-213.
18. Mermoud A, Schnyder CC, Michel E, et al. Comparison of deep sclerectomy with collagen implant and trabeculectomy in openangle. J Cataract Refract Surg, 1999, 25(3): 323-331.
19. 王宁利, 吴河坪, 叶天才. 非穿透小梁手术中术后早中期并发症疗效分析. 中华眼科杂志, 2002, 38(6): 329-334.
20. 王宁利, 梁远波, 庄雪梅, 等. 非穿透性手术的术后早期并发症及成本效果分析. 中华眼科学杂志, 2005, 41(6): 505-510.
21. 霍鸣, 李娟, 张海江, 等. 非穿透性与改良手术治疗开角型青光眼的远期疗效. 国际眼科学杂志, 2008, 8(2): 396-397.
22. 黄燕, 王宁利, 王班伟, 等. 非穿透性小梁手术治疗原发性开角型青光眼的远期疗效. 眼科学杂志, 2006, 15(14): 277-280.

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Non-penetrating Trabecular Surgery versus Trabeculectomy for Open Aangle Glaucoma: A Systematic Review

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