Clinical Research Of The Curative Effect Of Drainage Implantation On Glaucoma

Objective: To explore the difference of the efficacy of different surgical procedures for glaucoma,and to provide the basis for the selection of clinical treatment methods.Methods: Putting “glaucoma drainage implant”,“trabeculectomy”,“glaucoma filtration implant”and “aqueous shunt” as keywords,we systematically searched Pubmed,Web of science,EMBASE,Cochrane Library,CNKI,CBM,Wanfang,databases to identify the publication of clinical studies,from 1983 to 2015.After screening,we removed duplicate articles by applying endnote software and by hand,two researchers subsequently screened articles in the light of inclusion and exclusion criterias,evaluated the quality of the studies and extracting data.Based on the exclusion criteria,4 papers were selected.According to the parameters: the percentage of intraocular pressure decreased(IOPR%),the success rate of intraocular pressure in 1 year after operation,the success rate of intraocular pressure,the incidence of shallow anterior chamber,the incidence of hyphema,the incidence of leakage after surgery.The 113 cases who underwent EX-PRESS glaucoma drainage device implantation,59 cases underwent Ahmed glaucoma valve implantation,as the study of the intervention group(GDD group);179 cases underwent trabeculectomy as control group(group Tra).The literature software is used to analyze the literature.Recruited studies were examined by meta-analysis of Rev Man5.2 software.Results: There was no significant difference between GDD and trabeculectomy in the IOPR%(MD=-0.59;95%CI,-7.48-6.29;P =0.87),The operation of the two groups was similar to the effect of lowering intraocular pressure;The pooled OR comparing GDD to trabeculectomy for the complete success rate without any drug at one year after surgery were in favor of GDD(OR=5.80;95%CI,2.14-15.71,P =0.0006);The pooled OR comparing GDD to trabeculectomy for the qualified success rate with drug at one year after surgery were in favor of GDD(OR=2.51;95%CI,1.25-5.05;P =0.010);There was no significant difference between GDD and trabeculectomy in the complications after surgery.The GDD group did not make the incidence of postoperative complications increased.Conclusion: Compared to trabeculectomy,GDD has the similar effect of IOPR% and safety;GDD can significantly improve the success rate of surgery,it is an effective method for the treatment of glaucoma.