*School of Medicine, King's College London, London, United Kingdom; and †London School of Economics and Political Science, London, United Kingdom.
Retina. 2013 Nov-Dec;33(10):2012-7. doi: 10.1097/IAE.0b013e3182a6b3e2.
To determine the safety and efficacy of pars plana vitrectomy for vitreomacular traction.
Articles reporting visual acuity change before and after pars plana vitrectomy were selected using a systematic literature review with predefined eligibility criteria. Visual acuities were converted to logarithm of the minimum angle of resolution (logMAR), weighted for study size, and pooled across studies. Safety outcomes were also pooled across studies.
Twenty-one of 460 articles were eligible. Mean (±standard deviation) logMAR visual acuity improved from 0.67 ± 0.55 to 0.42 ± 0.45 (n = 259 eyes) after pars plana vitrectomy (from 20/94 to 20/53 Snellen). In series of at least 20 eyes, mean visual acuity improved in all 5 studies (sign test, P = 0.0625). Of 392 eyes, 9.2% lost visual acuity, 11.7% were unchanged, and 64.3% improved; 32.9% of 217 eyes gained ≥2 Snellen lines. The most common postoperative complications were cataract (34.7% of 304 eyes; 63.2% of 68 phakic eyes), epiretinal membrane (5.7% of 348 eyes), and retinal detachment (4.6% of 348 eyes). Cataract surgery was undertaken in 10.5% of eyes.
The visual acuity gains after pars plana vitrectomy for vitreomacular traction are relatively modest, but visual acuity change may not fully reflect symptomatic relief.
评估玻璃体切割术治疗玻璃体积血牵引的安全性和有效性。
通过系统文献回顾，根据预先设定的纳入标准，选择报告玻璃体切割术前、后视力变化的文章。将视力转换为最小角分辨率对数（logMAR），根据研究大小进行加权，并对研究进行汇总。安全性结果也在研究间进行汇总。
460 篇文章中有 21 篇符合纳入标准。玻璃体切割术后，259 只眼中（n=259 只眼）的平均（±标准差）logMAR 视力从 0.67±0.55 提高到 0.42±0.45（从 20/94 提高到 20/53 Snellen）。在至少 20 只眼的系列中，所有 5 项研究的平均视力均有改善（符号检验，P=0.0625）。在 392 只眼中，9.2%的眼视力下降，11.7%的眼视力不变，64.3%的眼视力提高；217 只眼中有 32.9%的眼提高了≥2 行 Snellen 视力。最常见的术后并发症是白内障（304 只眼中的 34.7%；68 只未植入晶状体眼中的 63.2%）、视网膜内膜（348 只眼中的 5.7%）和视网膜脱离（348 只眼中的 4.6%）。10.5%的眼接受了白内障手术。
玻璃体切割术治疗玻璃体积血牵引的视力提高相对较小，但视力变化可能不能完全反映症状的缓解。
