儿童白内障三种手术方式与后发障关系的Meta分析  

The after cataract following three different cataract surgeries in children:a Meta-analysis

作　　者：尹小磊[1] 袁容娣[1] 叶剑[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所眼科,重庆400042

出　　处：《中国斜视与小儿眼科杂志》2009年第2期49-55,共7页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的系统评价儿童白内障单纯手术方式、术中Ⅰ期联合后囊环形撕囊(posterior continuous curvilinear capsulorhexis,PCCC)及术中Ⅰ期联合PCCC并前段玻璃体切除(anterior vitrectomy,AV)与后发障的关系。方法检索多个数据库及相关资源,对9篇有关儿童白内障手术方式对后发障影响的文章进行Meta分析。以优势比(OR)判定儿童白内障术中选择单纯手术方式,PCCC及PCCC+AV术式对后发障的影响,计算失效安全数(fail-safe number, Nfs)进行敏感性分析。结果9篇文献中按研究内容分二部分:研究一为3篇,儿童白内障术中Ⅰ期联合PCCC的研究共130眼;研究二为6篇,对PCCC+AV术式和PCCC术式的对比研究共305眼。研究一OR值=0.34(95%置信区间:0.16～0.74),P=0.006;研究二OR值=0.13(95%置信区间:0.06～0.25),P<0.000。计算失效安全数进行敏感性分析,证实本研究结论可靠。结论儿童白内障手术中联合Ⅰ期后囊环形撕囊能有效降低后发障发生率,同时联合前段玻璃体切除后发障发生率更低。Objective To evaluate the effect of pediatric cataract surgery with posterior continuous curvilinear capsulorhexis（PCCC） with or without anterior vitrectomy（AV） on after cataract. Methods A comprehensive electric search and a manual search in related resource in English and Chinese. Strictly include and exclude the relevant articles with statistical criterion and get the needing data to Meta-analysis. Treatment effect was measured as odds ratio between pediatric cataract surgery with or without PCCC, and pediatric cataract surgery with PCCC with or without AV. Calculate the fail-safe number （Nfs） to assess the sensitivity and specificity of the research. Results In group 1, 3 articles with a sum of 130 eyes were included, and in group 2, 6 articles with 305 eyes. The pooled OR of after cataract in group 1 was 0.34（95%CI is 0.16-0.74）,and in group 2 it was 0.13（95% CI is 0.06-0.25）. Sensitivity analysis demonstrated that no disproportionate influences of individual study. Conclusions A theory that pediatric cataract surgery with posterior continuous curvilinear eapsulorhexis is superior to the one without on preventing after cataract, and pediatric cataract surgery with posterior continuous curvilinear capsulorhexis with anterior vitrectomy is more effective than the one without anterior vitrectomy could be used widely.

关 键 词：白内障 后囊环形撕囊 前段玻璃体切除 后发性白内障 META分析 

分 类 号：R779.66[医药卫生—眼科] R195.1[医药卫生—临床医学]