手术治疗孔源性视网膜剥离的Meta分析  

Meta-analysis of Surgical Treatments for Rhegmatogenous Retinal Detachment

作　　者：孙俏[1] 孙涛[1] 徐艺[1] 杨晓璐[1] 许迅[1] 

机构地区：[1]上海交通大学医学院附属第一人民医院眼科,上海200080

出　　处：《华西医学》2011年第6期912-918,共7页West China Medical Journal

摘　　要：目的对比玻璃体手术和巩膜环扎术对治疗非复杂性孔源性视网膜剥离(rhegmotogenous retinaldetachment,RRD)的疗效。方法检索Pubmed、Embase、Cochrane对照试验中心注册数据库,对相关的随机对照临床试验(randomized controlled trialc,RCT)按Cochrane协作网推荐的方法进行Meta分析。结果有晶状体组包括3篇RCT共523例,人工晶状体/无状晶体组包括4篇RCT共690例。有晶状体组玻璃体手术(pars planavitrectomy,PPV)术后白内障的发生率更高[OR=4.18,95%CI(2.75,6.35),P<0.000 01]。人工晶状体/无晶状体组PPV术后最终解剖复位率更高[OR=1.97,95%CI(1.04,3.73),P=0.04]。结论巩膜环扎术通过降低术后白内障的发生率在治疗非复杂性有晶状体眼RRD中占有优势;PPV可提高最终解剖复位率,更适合人工晶状体/无晶状体眼RRD。Objective To compare the efficacy of pars plana vitrectomy（PPV） and scleral buckling（SB） in treating uncomplicated rhegmatogenous retinal detachment（RRD）.Methods Randomized controlled trials（RCTs） were searched from Pubmed,Embase and the Cochrane Central Register.Meta-analysis was conducted using the methods recommended by the Cochrane Collaboration.Results Three RCTs with 523 phakic eyes and four RCTs with 690 pseudophakic/aphakic eyes were included.In the phakic group,the rate of postopertative cataract was higher with PPV [OR=4.18,95% CI（2.75,6.35）,P0.000 01].In the pseudophakic/aphakic group,final anatomic success outcome was in favor of PPV [OR=1.97,95% CI（1.04,3.73）,P=0.04].Conclusions SB results better in terms of postoperative cataract in phakic RRDs.PPV is more likely to achieve a favorable final reattachment in pseudophakic/aphakic RRDs.

关 键 词：孔源性视网膜剥离 手术治疗 META分析 

分 类 号：R779.6[医药卫生—眼科]