Korah Sanita, Philip Swetha, Jasper Smitha, Antonio-Santos Aileen, Braganza Andrew
Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India, 632001.
Cochrane Database Syst Rev. 2014 Oct 15;2014(10):CD009272. doi: 10.1002/14651858.CD009272.pub2.
Normal visual development occurs when the brain is able to integrate the visual input from each of the two eyes to form a single three-dimensional image. The process of development of complete three-dimensional vision begins at birth and is almost complete by 24 months of age. The development of this binocular vision is hindered by any abnormality that prevents the brain from receiving a clear, similar image from each eye, due to decreased vision (e.g. amblyopia), or due to misalignment of the two eyes (strabismus or squint) in infancy and early childhood. Currently, practice patterns for management of a child with both strabismus and amblyopia are not standardized.
To study the functional and anatomic (ocular alignment) outcomes of strabismus surgery before completion of amblyopia therapy as compared with surgery after completion of amblyopia therapy in children under seven years of age.
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2014), EMBASE (January 1980 to July 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to July 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 24 July 2014. A manual search for articles from a review of the references of the selected publications and conference abstracts was completed to identify any additional relevant studies.
We searched for randomized controlled trials (RCTs) that provided data on strabismus surgery in children less than seven years of age, performed after initiation of, but before completion of amblyopia therapy, as compared with strabismus surgery after completion of amblyopia therapy.
Two authors independently assessed studies identified from the electronic and manual searches.
There were no RCTs that fit our inclusion criteria and so no analysis was possible.
AUTHORS' CONCLUSIONS: As there are no RCTs currently available and the best existing evidence is only from non-randomized studies, there is a need for prospective RCTs to investigate strabismus surgery in the presence of strabismic amblyopia. The optimal timing of when to perform strabismus surgery in children with amblyopia is unknown.
当大脑能够整合来自双眼的视觉输入以形成单个三维图像时，正常的视觉发育就会发生。完整三维视觉的发育过程始于出生时，到24个月大时几乎完成。由于视力下降（如弱视），或由于婴幼儿期双眼的不对准（斜视），任何阻止大脑从每只眼睛接收清晰、相似图像的异常情况都会阻碍这种双眼视觉的发育。目前，斜视和弱视患儿的治疗模式尚未标准化。
研究7岁以下儿童在弱视治疗完成前进行斜视手术与弱视治疗完成后进行斜视手术的功能和解剖学（眼位对准）结果。
我们检索了Cochrane眼科和视力组试验注册库（CENTRAL）（2014年第6期）、Ovid MEDLINE、Ovid MEDLINE在研及其他未索引引文、Ovid MEDLINE日报、Ovid OLDMEDLINE（1946年1月至2014年7月）、EMBASE（1980年1月至2014年7月）、拉丁美洲和加勒比健康科学文献数据库（LILACS）（1982年1月至2014年7月）、对照试验元注册库（mRCT）（www.controlled-trials.com）、ClinicalTrials.gov（www.clinicaltrials.gov）以及世界卫生组织（WHO）国际临床试验注册平台（ICTRP）（www.who.int/ictrp/search/en）。在电子检索试验时，我们未使用任何日期或语言限制。我们最近一次检索电子数据库是在(2014年7月24日)。通过对所选出版物的参考文献和会议摘要进行回顾，完成了手动检索文章以识别任何其他相关研究。
我们检索了随机对照试验（RCT），这些试验提供了7岁以下儿童在弱视治疗开始后但完成前进行斜视手术与弱视治疗完成后进行斜视手术的数据。
两位作者独立评估了从电子检索和手动检索中识别出的研究。
没有符合我们纳入标准的RCT，因此无法进行分析。
由于目前没有RCT，现有的最佳证据仅来自非随机研究，因此需要进行前瞻性RCT来研究斜视性弱视情况下的斜视手术。弱视患儿进行斜视手术的最佳时机尚不清楚。
