Turner A, Rabiu M
Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria, Australia, 3002.
Cochrane Database Syst Rev. 2006 Apr 19(2):CD004764. doi: 10.1002/14651858.CD004764.pub2.
Recent audits show that corneal abrasion is a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions.
The objective of this review was to test the hypothesis that patching an eye following a corneal abrasion improves healing or provides pain relief.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) on The Cochrane Library (2005, Issue 2), MEDLINE (1966 to April 2005), EMBASE (1980 to April 2005), LILACS (13 April 2005), NRR (2005, Issue 2) and SIGLE (December 2004). There were no language or date restrictions in the searches. We also searched the reference lists of included studies, unpublished 'grey' literature and conference proceedings and contacted pharmaceutical companies for details of unpublished trials.
We included randomised and quasi-randomised controlled trials that compared patching the eye with no patching to treat simple corneal abrasions.
Two authors independently assessed trial quality and extracted data. We contacted investigators for further information regarding quality of trials. The primary outcome was healing of the corneal epithelium and secondary outcomes were related to pain.
Eleven trials, which randomised a total of 1014 participants, were included in the review. Meta-analysis of seven studies with dichotomous healing outcomes favoured no patching on the first day of healing (risk ratio (RR) 0.89, 95% Confidence Interval (CI) 0.79 to 0.99). For days two and three there was no significant difference between the two groups. Of the nine trials that measured pain scores two favoured no patching and none favoured patching. Complication rates were low and no differences were noted in these between the two groups. No-patch groups generally received more adjuvant treatment with antibiotics and/or cycloplegics than the patch group which is an important confounding factor.
AUTHORS' CONCLUSIONS: Treating simple corneal abrasions with a patch does not improve healing rates on the first day post-injury and does not reduce pain. In addition, use of patches results in a loss of binocular vision. Therefore it is recommended that patches should not be used for simple corneal abrasions. Further research should focus on large (greater than 10 mm(2)) abrasions.
近期的审计表明，角膜擦伤是一种常见的眼部就诊主诉。尽管缺乏使用眼罩的证据，但眼罩仍常被推荐用于治疗角膜擦伤。本系统评价旨在确定眼罩用于治疗角膜擦伤的效果。
本评价的目的是检验以下假设：角膜擦伤后包扎眼睛可促进愈合或缓解疼痛。
我们检索了Cochrane图书馆（2005年第2期）中的Cochrane对照试验中心注册库（CENTRAL）（其中包含Cochrane眼科和视力组试验注册库）、MEDLINE（1966年至2005年4月）、EMBASE（1980年至2005年4月）、LILACS（2005年4月13日）、NRR（2005年第2期）和SIGLE（2004年12月）。检索无语言或日期限制。我们还检索了纳入研究的参考文献列表、未发表的“灰色”文献和会议论文集，并联系制药公司获取未发表试验的详细信息。
我们纳入了比较包扎眼睛与不包扎眼睛治疗单纯角膜擦伤的随机和半随机对照试验。
两位作者独立评估试验质量并提取数据。我们联系研究者获取关于试验质量的进一步信息。主要结局是角膜上皮愈合，次要结局与疼痛相关。
本评价纳入了11项试验，共随机分配了1014名参与者。对7项具有二分法愈合结局的研究进行的荟萃分析表明，在愈合第一天不包扎更有利（风险比（RR）0.89，95%置信区间（CI）0.79至0.99）。在第二天和第三天，两组之间无显著差异。在9项测量疼痛评分的试验中，两项试验表明不包扎更有利，没有一项试验表明包扎更有利。并发症发生率较低，两组之间未发现差异。不包扎组比包扎组通常接受更多抗生素和/或睫状肌麻痹剂的辅助治疗，这是一个重要的混杂因素。
用眼罩治疗单纯角膜擦伤在受伤后第一天并不能提高愈合率，也不能减轻疼痛。此外，使用眼罩会导致双眼视力丧失。因此，建议不将眼罩用于单纯角膜擦伤。进一步的研究应聚焦于大面积（大于10平方毫米）的擦伤。
