内界膜翻转填塞与内界膜剥除治疗高度近视黄斑裂孔视网膜脱离的Meta分析
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国家自然科学基金资助项目(No.81660162); 遵义市创新人才团队培养项目\〖No.遵市科合(2015)43号\〗; 贵州省科技计划项目\〖No.黔科合SY字(2013)3036号\〗


A Meta-analysis of the efficacy of internal limiting membrane reversal tamponade and internal limiting membrane stripping for macular hole retinal detachment in the highly myopia eyes
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National Natural Science Foundation of China(No.81660162); Zunyi Innovative Talent Team Training Project \〖No.(2015)43\〗; Guizhou Province Science Foundation \〖No.(2013)3036\〗

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    摘要:

    目的:评价玻璃体切除(PPV)联合内界膜(ILM)翻转填塞或ILM剥除在治疗高度近视黄斑裂孔视网膜脱离(MHRD)中解剖学及视力恢复疗效。

    方法:从中国知网(CNKI)、维普(VIP)、万方数据库(Wan Fang Database)、PubMed、EMbase、The Cochrane Library、Europe PMC、Nature数据库中检索文献,检索时间均为建库至2018-09。以术后6mo为随访时间节点,观察黄斑裂孔闭合、原发性视网膜复位及BCVA情况。采用Review 5.3及Stata 15.1软件进行Meta分析。

    结果:本研究包括8项研究266眼。ILM翻转填塞在黄斑裂孔闭合率方面优于ILM剥除(RR=2.05,95%CI 1.69~2.49,P<0.00001),在原发性视网膜复位率方面无差异(RR=1.04,95%CI 0.98~1.12,P=0.21),在术后6mo两组BCVA均较术前明显提高(分别为:RR=0.44,95%CI 0.33~0.55,P<0.00001; RR=0.29,95%CI 0.10~0.48,P=0.003),两组间BCVA改善程度的差异结果存在异质性,其结论可能不稳定,尚需更多可靠数据证明。

    结论:PPV联合ILM翻转填塞在治疗高度近视MHRD患者中更有效。

    Abstract:

    AIM: To evaluate the anatomical and visual recovery effects of vitrectomy(PPV)combined with inner limiting membrane(ILM)reversal tamponade or ILM stripping in the treatment of high myopia macular hole retinal detachment(MHRD).

    METHODS:The literature was retrieved from China Knowledge Network(CNKI), VIP, Wanfang Database, PubMed, EMbase, Cochrane Library, European PMC, and Natural database. The search time was built until September 2018. The 6-month follow-up time was used to observe the macular hole closure, primary retinal detachment and BCVA. Meta-analysis was performed using Review 5.3 and Stata 15.1 software.

    RESULTS: In this study, a comparative analysis of 266 eyes in 8 studies was included. Statistically, the effect of ILM reversal tamponade in the macular hole closure rate is better than ILM stripping, the difference was statistically significant(RR=2.05, 95% CI 1.69 to 2.49, P<0.00001), there was no statistically significant difference in the efficacy of primary retinal detachment rate(RR=1.04, 95% CI 0.98 to 1.12, P=0.21), the BCVA of the two groups was significantly higher than that before surgery at 6mo after surgery, the difference was statistically significant(RR=0.44, 95% CI 0.33 to 0.55, P<0.00001; RR=0.29, 95% CI 0.10 to 0.48, P=0.003). The results of the extent of BCVA improvement between the two groups are heterogeneous, and the conclusions may be unstable, and more reliable data are needed.

    CONCLUSION: PPV+ ILM flap insertion is more effective in treating patients with high myopia macular hole retinal detachment.

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黄智华,谭薇,张英,等.内界膜翻转填塞与内界膜剥除治疗高度近视黄斑裂孔视网膜脱离的Meta分析.国际眼科杂志, 2019,19(4):571-576.

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  • 收稿日期:2018-11-16
  • 最后修改日期:2019-03-06
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  • 在线发布日期: 2019-03-22
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