Generando matriz de evidencia

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Una característica única de Epistemonikos es que conecta las revisiones sistemáticas y sus estudios incluidos. Esto hace posible agregar las revisiones sistemáticas en base a los estudios primarios que tienen en común. El concepto de "revisiones sistemáticas compartiendo estudios incluidos" es un proxy de "revisiones sistemáticas respondiendo una pregunta similar"

Una matriz de evidencia es una forma tabular de desplegar el conjunto de revisiones sistemáticas que comparten estudios incluidos, y todos los estudios incluidos en estas revisiones. Es creado automáticamente a partir de las conexiones existentes en la base de datos, y puede ser editado por el usuario para que refleje más exactamente el conjunto de evidencia para la pregunta específica.

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La matriz de evidencia que será creada a partir de esta revisión contiene Revisiones sistemáticas / Estudios primarios. loading

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La matriz de evidencia es creada en base a los estudios primarios que las revisiones sistemáticas tienen en común. Por esta razón no es posible generar una matriz de evidencia desde una revisión que no incluyó ningún estudio

Este documento no permitirá generar una matriz hasta que los colaboradores de Epistemonikos completen la subida de información relevante. Si quiere que sea priorizada envía un correo a matrix@epistemonikos.org

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16 Referencias (9 Estudios primarios) Estudificar 68.8%Ensayo controlado aleatorizado (ECA)11 / 16
Tae Yoon Lee, M..2008Wilson MR2000Gedde SJ2007Wilson MR2003Gedde SJ2012Pakravan M2007Gedde SJ2007Rauscher FM2009Gedde SJ2009Shen CC2011Tran DH2009Gedde SJ2005Im YW, Lym HS, ..2004Gedde SJ2010Gedde SJ2012Bluestein EC1993
5 Revisiones sistemáticas
Tseng, Victori..2017Minckler DS2008Tice JA2011HaiBo T2015Hong CH2005
10 Referencias ( articles) loading Revertir Estudificar

Estudio primario

No clasificado

Clinical experience with the Baerveldt 250-mm2 Glaucoma Implant.

Revista Ophthalmology
Año 2006
Enlaces Pubmed DOI
Cargando información sobre las referencias
PURPOSE: To report the intermediate-term results of the Baerveldt 250-mm2 Glaucoma Implant for treatment of adult glaucoma. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: One hundred eight adult patients (108 eyes) with glaucoma who received a Baerveldt 250-mm2 Glaucoma Implant. INTERVENTION: Implantation of the Baerveldt 250-mm2 Glaucoma Implant. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), visual acuity, number of glaucoma medications, and surgical complications. Success was defined as IOP > or = 6 mmHg and < or = 21 mmHg (with or without antiglaucoma medications), without further glaucoma surgery, devastating complication, or loss of light perception attributable to drainage implantation. RESULTS: Mean age was 63.8+/-16.5 years. Mean postoperative follow-up was 22.8 months (range, 0.2-84.9; interquartile range, 3.9-36.3). Mean preoperative IOP was 36.3+/-13.0 mmHg, on 2.9+/-1.1 antiglaucoma medications. The mean postoperative IOP at final visit was 15.8+/-7.6 mmHg (P<0.0001, paired t test), on 0.8+/-1.0 antiglaucoma medications (P<0.0001, Wilcoxon test). Kaplan-Meier success rates were 0.92 (6 months, n = 81), 0.88 (12 months, n = 75), 0.84 (18 months, n = 68), and 0.79 (24 months, n = 61). CONCLUSIONS: The Baerveldt 250-mm2 Glaucoma Implant provides good intermediate-term success for the treatment of adult refractory glaucoma.

Estudio primario

No clasificado

Baerveldt glaucoma implant in paediatric patients.

Revista The British journal of ophthalmology
Año 2006
Enlaces Pubmed DOI PubMed Central
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AIM: To evaluate the Baerveldt glaucoma implant (BGI) in paediatric glaucoma treatment. METHODS: In a retrospective non-comparative case series 55 eyes of 40 consecutive paediatric patients (< or =16 years) with primary or secondary glaucoma underwent Baerveldt (350 mm2) implantation. Surgical outcome was evaluated by Kaplan-Meier table analysis. RESULTS: The overall success rate was 80% at last follow up, with a mean follow up of 32 (range 2-78) months. Cumulative success was 94% at 12 months and 24 months, 85% at 36 months, 78% at 48 months, and 44% at 60 months. 11 eyes (20%) failed postoperatively because of an IOP >21 mm Hg (eight eyes), persistent hypotony (two eyes), and choroidal haemorrhage following cataract surgery (one eye). The most frequent complication needing surgery was tube related (20%). A new observation was mild to moderate dyscoria in 22% of the eyes, all buphthalmic, caused by entrapment of a tuft of peripheral iris in the tube track. CONCLUSIONS: The BGI is effective and safe in the management of primary and secondary glaucoma. When angle surgery has proved to be unsuccessful or inappropriate in paediatric patients, a BGI is a good treatment option. One must be prepared to deal with the tube related problems.

Estudio primario

No clasificado

Ahmed Glaucoma Valve implantation in African American and white patients.

Autores Ishida K , Netland PA
Revista Archives of ophthalmology (Chicago, Ill. : 1960)
Año 2006
Enlaces Pubmed DOI
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OBJECTIVE: To evaluate the results of Ahmed Glaucoma Valve implantation in African American and white patients. METHODS: In this retrospective, comparative case-control study, we reviewed 86 eyes of 86 patients, comparing the surgical outcomes in white patients (n = 43) with matched African American patients (n = 43). Success was defined as an intraocular pressure (IOP) between 6 mm Hg and 21 mm Hg with or without glaucoma medicines, without further glaucoma surgery, and without loss of light perception (definition 1) and an IOP between 6 mm Hg and 21 mm Hg and achievement of a 20% reduction in IOP from the preoperative level (definition 2). RESULTS: The mean follow-up was 2.3 years for white patients and 2.5 years for African American patients (P = .50). At the last follow-up, the mean +/- SD IOP was 15.3 +/- 3.3 mm Hg and 15.3 +/- 3.5 mm Hg (P = .77) in white and African American patients, respectively. Life table analysis showed a significantly lower success rate for African American patients compared with white patients by both definition 1 (P = .03) and definition 2 (P = .006). Cox proportional hazards regression analysis detected African American race as a risk factor for surgical failure by both definitions. Visual outcomes and complications were comparable between the 2 groups. CONCLUSION: African American patients have a greater risk of surgical failure after Ahmed Glaucoma Valve implantation compared with white patients.

Estudio primario

No clasificado

The long-tube single plate Molteno implant for the treatment of recalcitrant glaucoma.

Autores Traverso CE , Tomey KF , al-Kaff A
Revista International ophthalmology
Año 1989
Enlaces Pubmed
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One hundred cases of recalcitrant glaucoma were operated with a long tube single-plate Molteno implant (LSMI). At the median follow-up of 15 months an intraocular pressure of less than or equal to 19 mm Hg was obtained in 64 of the 87 eyes (73%) which have a minimum follow-up of 6 months (secondary non-neovascular glaucomas = 19; congenital glaucomas = 26; secondary neovascular glaucomas = 12). The interval probability (percentage +/- standard error) of obtaining a successful result (IOP less than or equal to 19 mm Hg) was 79% (+/- 13) at twelve months from surgery, and 53% (+/- 24) at the eighteen month interval. The least favorable results were obtained in the secondary non-neovascular glaucomas. Complications observed included choroidal detachment (24%), tube exposure (4%), tube-endothelium contact (6%), plus band keratopathy, fibrous ingrowth, traction retinal detachment and corneal ulcers. Seventeen cases needed repeated surgery for the management of complications. In order to decrease the post-operative hypotony, we have been using a tourniquet suture around the tube at the time of implantation to occlude it temporarily and limit the outflow.

Estudio primario

No clasificado

Glaucoma drainage implants in Asian eyes.

Autores Aung T , Seah SK
Revista Ophthalmology
Año 1998
Enlaces Pubmed DOI
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OBJECTIVE: Previous studies have suggested that there are racial differences in the outcome of conventional filtration surgery. This study aims to evaluate the outcome of glaucoma drainage implants in Asian eyes with complicated glaucoma and to determine whether there are racial differences in the results of such implant surgery compared to previous reports in non-Asian patients. DESIGN: The study design was a retrospective review of all patients with more than 6-months' follow-up after glaucoma implant surgery at the Singapore National Eye Centre between January 1993 and August 1996. PARTICIPANTS: A total of 83 Asian patients with uncontrolled complicated glaucoma participated. INTERVENTION: A total of 29 patients received Molteno implants and 54 received Baerveldt implants. MAIN OUTCOME MEASURES: The surgical outcome was assessed in terms of final intraocular pressure (IOP), visual acuity outcome, and incidence of complications. Success was defined as final IOP less than 22 mmHg with no medications and qualified success as an IOP less than 22 mmHg with medication. RESULTS: With mean follow-up of 13.41 months, success in IOP control was achieved in 73.5% of patients and qualified success in 12%. Visual acuity remained stable or improved in 85.5%. There were no patients who encountered intraoperative complications, and the incidence of serious postoperative complications was low. The most frequently observed short- and long-term postoperative complication was hyphema in 14 eyes (16.9%) and bullous keratopathy in 7 eyes (8.4%), respectively. CONCLUSIONS: Glaucoma drainage implants have good outcome and visual stabilization in Asian eyes with success rates for IOP control comparable to those reported in previous studies in non-Asian eyes.

Estudio primario

No clasificado

Survival analysis for success of Molteno tube implants.

Revista The British journal of ophthalmology
Año 2001
Enlaces Pubmed PubMed Central
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AIM: To apply survival analysis in assessing the long term outcome of Molteno tube implantation and to identify risk factors for failure. METHODS: A retrospective, 10 year, consecutive case series study of 119 eyes that underwent implantation of a Molteno tube. The main outcome measures considered were intraocular pressure (IOP), visual acuity, and complications. RESULTS: A 30% or greater reduction in IOP was achieved in 68.9% of cases. However, the overall, "complete success" rate (IOP <22 mm Hg with no medications) after a mean (SD) follow up period of 43 (33) months (range 6-120) was only 33.6% despite a fall in mean (SD) IOP from 38.2 (8.2) mm Hg to 20.1 (11.0) mm Hg. The "qualified success" rate (IOP <22 mm Hg with or without medications) was 60.5%. Failure was most common in the first postoperative year but could occur after several years, the survival curve having an exponential shape. The only statistically significant risk factor for failure identified was pseudophakia, although eyes with neovascular glaucoma tended to fare poorly. Postoperative IOP tended to be lower after double plate than after single plate implantation. There was no significant difference in outcome based on age, sex, race, previous penetrating keratoplasty, or previous conjunctival surgery. CONCLUSIONS: In eyes at high risk of trabeculectomy failure, implantation of an aqueous shunt device should be considered. Pseudophakia should be considered an additional risk factor for failure. Early failure appeared relatively more common but long term follow up of all cases is recommended to ensure adequate management of late failures.

Estudio primario

No clasificado

Internal suture occlusion of the Molteno glaucoma implant for the prevention of postoperative hypotony.

Autores Egbert PR , Lieberman MF
Revista Ophthalmic surgery
Año 1989
Enlaces Pubmed
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The Molteno glaucoma drainage implant procedure is useful for managing refractory glaucoma, but a significant concern has been the avoidance of postoperative hypotony due to temporary excessive filtration. We have developed a method of temporarily closing the translimbal tube with an internally-placed occluding suture (4-0 or 5-0 chromic). Seven to 12 days later this suture was removed, without surgery, in an outpatient setting. We have used this method on 30 patients. The advantages are that postoperative hypotony is reduced, and the Molteno drainage implant can be inserted in a single operation.

Estudio primario

No clasificado

Long-term results of Molteno implant insertion in cases of neovascular glaucoma.

Revista Archives of ophthalmology (Chicago, Ill. : 1960)
Año 2006
Enlaces Pubmed DOI
Cargando información sobre las referencias
OBJECTIVE: To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno implants. METHODS: A prospective study of 145 eyes (130 patients) followed up for a mean of 3.3 years (range, 0.02 year [5 days] to 18.1 years) in the province of Otago, New Zealand, from 1979 to 2002. RESULTS: Insertion of a Molteno implant controlled the intraocular pressure at 21 mm Hg or less with a probability (95% confidence interval) of 0.72 (0.64-0.80), 0.60 (0.51-0.69), and 0.40 (0.29-0.50) at 1, 2, and 5 years, respectively. Failure to control intraocular pressure at 1, 2, and 5 years was significantly correlated with persistent iris neovascularization (P<.001, P<.001, and P = .01, respectively). Visual acuity at final follow-up in nonenucleated eyes was maintained or improved in 56 eyes (39%) and deteriorated to light perception or better in 25 (17%) or no light perception in 47 (32%). Seventeen eyes (12%) were enucleated. CONCLUSIONS: The insertion of Molteno implants for neovascular glaucoma maintained or improved vision in 39% of eyes, whereas 12% were eventually enucleated (all of which initially had visual acuity <20/1200). The outcome depended mainly on progression of the underlying vascular disease.

Estudio primario

No clasificado

Molteno implant surgery in uncontrolled glaucoma.

Revista Acta ophthalmologica
Año 1990
Enlaces Pubmed
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Molteno implant surgery was performed on 33 eyes of 29 patients with complicated and uncontrolled glaucoma. Average preoperative IOP was 34.0 +/- 8.8 mmHg. After a mean postoperative follow-up period of 18.3 months the IOP was 15.8 +/- 8.3 mmHg. Three patients had an IOP over 22 mmHg. Overall, success rate was 73% with IOP and medication as criteria. In 75% of eyes visual acuity improved or remained within two lines of the preoperative value. The highest success rate was 83% (10 of 12 eyes) in congenital and uveitic glaucoma when both IOP, medication and visual acuity were taken into account. At the end of the study 52% of eyes were controlled without medication. Complications included transient hyphema (21%), flat anterior chamber with hypotony, with or without choroidal detachment (12%), tube touch to lens or cornea (9%), and tube block with vitreous (3%).

Estudio primario

No clasificado

Early clinical experience with the Baerveldt implant in complicated glaucomas.

Revista American journal of ophthalmology
Año 1995
Enlaces Pubmed
Cargando información sobre las referencias
PURPOSE: To evaluate our early experience with the Baerveldt implant in patients with complicated glaucoma. METHODS: We reviewed the charts of all patients with more than six months of follow-up after placement of a Baerveldt implant at LSU Eye Center. Surgery was considered a success if intraocular pressure was 21 mm Hg or less (with or without antiglaucoma medications) at the last postoperative visit, except when further glaucoma surgery had been performed or when loss of light perception occurred. RESULTS: Fifty eyes (50 patients) were divided into six diagnostic groups, with mean follow-up times of 16.1 to 19.2 months. Success was achieved in 36 of 50 patients (72%): 26 of 35 (74%) patients with aphakia or pseudophakia, nine of 12 (75%) patients with previously failed filtering surgery, three of seven patients with neovascular glaucoma, all three patients under the age of 13 years, nine of 13 (69%) patients who underwent penetrating keratoplasty, and four of five phakic patients. Overall, visual acuity improved or remained within one line of the preoperative acuity in 32 (64%) patients. The most frequently observed short- and long-term complications were serous choroidal effusion associated with hypotony in 13 (26%) patients and corneal graft failure in six of 13 (46%) corneal transplant patients, respectively. CONCLUSION: Within the study follow-up time, the Baerveldt implant appeared to be safe and effective, with success rates for intraocular pressure control similar to those reported in a recent retrospective study of the Molteno implant.
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