白内障超声乳化吸除术对糖尿病视网膜病变进展影响的Meta分析  

The influence of cataract phacoemulsification on progression of diabetic retinopathy and diabetic macular edema: a Meta-analysi

作　　者：刘巨平[1] 胡博杰[1] 程朝晖[1] 李筱荣[1] 

机构地区：[1]天津医科大学眼科医院,300384

出　　处：《眼科》2013年第6期378-382,共5页Ophthalmology in China

摘　　要：目的采用Meta分析的方法系统评价白内障超声乳化吸除术对糖尿病合并白内障患者术后糖尿病视网膜病变进展及糖尿病性黄斑水肿发生率的影响。设计系统综述。研究对象Medline、EMbase、Cochrone图书馆及中国生物医学文献数据库和中国期刊全文数据库中一眼行白内障超声乳化术，对侧未手术眼作为对照的糖尿病合并白内障患者为研究对象的文献。方法对纳入文献进行Meta分析。计算机检索上述数据库，同时手工检索相关书籍、期刊和会议论文及其参考文献。依据纳入和排除标准筛选文献，对纳入研究进行数据提取。统计学分析采用RevMan5．0软件，二分类变量采用比值比（OR）及其95％置信区间叫来表示。主要指标白内障超声乳化吸除术后双眼糖尿病视网膜病变的进展率及糖尿病性黄斑水肿的发生率。结果7项研究纳入分析，其中手术眼579眼，对侧未手术眼574眼作为对照。手术眼术后糖尿病视网膜病变进展率高于对侧未手术眼（OR=1．47，95％CI：1．09～1．98，P=0．01）。手术眼术后糖尿病性黄斑水肿发生率高于对侧未手术眼（OR=I．89，95％CI：1．05～3．39，P=0．03）。结论白内障超声乳化吸除术会加速糖尿病合并白内障患者糖尿病视网膜病变进程且增加糖尿病性黄斑水肿的发生率，但仍需大样本、长期随访的研究进一步证实。Objective To evaluate the influence of cataract phacoemulsification on progression of diabetic retinopathy （DR） and occurrence of diabetic maeular edema （DME） in diabetic patients. Design Systemic review. Participants Published literatures in Meal- line, EMbase, Cochrane library and CBM which comparing the progression of DR and DME between the eyes accepted the cataract phacoemulsifieation and the fellow eyes which were not accepted the surgeries. Methods This was a meta-analysis of prospective paired cohort study. A computerized search was performed in the databases with manually searching of bibliographies of pertinent articles, jom-nals and literature reference proceedings. According to inclusion and exclusion criteria, data extraction was conducted from included studies. The statistical analysis was performed by software RevMan5.0. The odds ratio （OR） and 95% confidence interval （C/） was calcu- lated for dichotomous variables. Main Outcome Measures Progression of diabeiic retinopathy, and occurrence of diabetic macular edema after cataract phaeoemulsification. Results Totally seven studies were included in the Meta-analysis involving 579 operated eyes and 574 non-operated contralateral eyes. The operated eyes gained a higher progression rate of diabetic retinopathy than the non-operat- ed eyes （OR=1.47, 95%CI： 1.09-1.98, P=0.01）. The similar result was achieved on the occurrence of diabetic macular edema （OR=1.89, 95%C1： 1,05~3.39, P=0.03）. Conclusion Cataract phacoemulsification could accelerate the progression of diabetic retinopathy and in- crease the incidence of diabetic macular edema. However a high-quality, large sample and long-term clinical trials are warranted to be further investigated.

关 键 词：超声乳化白内障吸除术 糖尿病视网膜病变 糖尿病性黄斑水肿 META分析 

分 类 号：R779.66[医药卫生—眼科]