The evidence that these devices are as safe as trabeculectomy alone is unclear. When we examined outcomes within subgroups based on the type of device used, our findings suggested that the use of an Ex‐PRESS device or an amniotic membrane as an adjunct to trabeculectomy may be slightly more effective in reducing IOP at one year after surgery compared with trabeculectomy alone. Overall, the use of devices with standard trabeculectomy may help with greater IOP reduction at one‐year follow‐up than trabeculectomy alone however, due to potential biases and imprecision in effect estimates, the quality of evidence is low. The one Gelfilm study reported uncertainty in the difference in IOP and complication rates between the two groups at one year no further data were provided in the study report. Hypotony was the only postoperative complication observed less frequently in the E‐PTFE group compared to the trabeculectomy‐alone group (RR 0.29, 95% CI 0.11 to 0.77). The report from the only E‐PTFE study (60 eyes) showed no important differences for postoperative IOP at one year (MD ‐0.44 mm Hg, 95% CI ‐1.76 to 0.88) between the trabeculectomy + E‐PTFE versus the trabeculectomy‐alone groups. Low‐quality evidence showed that use of amniotic membrane may prevent adverse events and complications, such as hypotony (RR 0.40, 95% CI 0.17 to 0.94, 5 studies, low‐quality evidence). Low‐quality evidence from nine studies suggests that use of amniotic membrane with trabeculectomy may be associated with lower IOP at one year compared with trabeculectomy alone (MD ‐3.92 mm Hg, 95% CI ‐5.41 to ‐2.42 356 eyes). Differences between the two treatment groups for other reported complications also were inconclusive. The effect of Ologen on preventing hypotony was uncertain (RR 0.75, 95% CI 0.47 to 1.19, 5 studies, very low‐quality evidence). Very low‐quality evidence from five studies suggests that use of Ologen compared with trabeculectomy alone is associated with slightly higher IOP at one year (MD 1.40 mm Hg, 95% CI ‐0.57 to 3.38 177 eyes). All these studies received funding from the device manufacturer. The effect of whether Ex‐PRESS prevents hypotony was uncertain (RR 0.92, 95% CI 0.63 to 1.33, 2 studies, very low‐quality evidence). Cataract surgery and hyphema may be less frequent in the Ex‐PRESS group than in the trabeculectomy‐alone group (cataract surgery: risk ratio (RR) 0.32, 95% CI 0.14 to 0.74, 3 studies, low‐quality evidence hyphema: RR 0.33, 95% CI 0.12 to 0.94, 4 studies, low‐quality evidence). Low‐quality evidence from three studies showed that use of Ex‐PRESS compared with trabeculectomy alone may be associated with a slightly lower IOP at one year (mean difference (MD) ‐1.58 mm Hg, 95% confidence interval (CI) ‐2.74 to ‐0.42 165 eyes). Only two studies explicitly masked outcome assessment so, we rated 31 studies at high risk of detection bias. The studies were reported poorly which limited our ability to judge risk of bias for many domains. Planned participant follow‐up periods ranged from three months to five years. These studies were conducted in North America, South America, Europe, Asia, and the Middle East. Five studies reported the use of Ex‐PRESS (386 participants), eight studies reported the use of Ologen (327 participants), 18 studies reported the use of amniotic membrane (726 participants), one study reported the use of E‐PTFE (60 participants), and one study reported the use of Gelfilm (43 participants). The 33 studies included a total of 1542 participants with glaucoma, and compared five types of devices implanted during trabeculectomy versus trabeculectomy alone. Run through time itself! Aeon Drive features a unique time-warping system that saves players the frustration of repetition and keeps the challenge fresh.We found 33 studies that met our inclusion criteria, of which 30 were published as full‐length journal articles and three as conference abstracts. With the power sword, teleportation dagger and unique skill to control time, Jackelyne has to find all the Drive Cores to fix her ship - and save the city from impending doom. Desperately trying to get home, she crash-lands her spaceship into the middle of a bustling metropolis, Neo Barcelona. You’ll play as Jackelyne, a young space ranger from another dimension. Set in the neon-colored landscape of Neo Barcelona, Aeon Drive is an action platformer with a speedrunning twist!
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |