Shi Hui, Guo Tao, Liu Peng-Cheng, Wang Qian-Yi, Du Ya-Ru, Liu Qing-Yu, He Meng-Mei, Liu Jun-Ling, Yu Jing
Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Nanjing, Jiangsu, People's Republic of China ; Department of First Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Department of Ophthalmology, Shanghai Third People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Drug Des Devel Ther. 2015 Mar 6;9:1393-400. doi: 10.2147/DDDT.S80983. eCollection 2015.
This meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD) surgery.
RRD patients with or without proliferative vitreoretinopathy (PVR) were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials.
Three randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I (2)=48%, P=0.14). However, the incidence of postoperative PVR was lower in the treatment group (I (2)=0%, P<0.0001) than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio -0.18; 95% confidence interval -0.38, 0.02; P=0.08). The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure.
This systematic review demonstrates that steroids may significantly reduce the incidence of postoperative PVR grade B or lower following RRD surgery.
进行这项荟萃分析以确定类固醇作为孔源性视网膜脱离（RRD）手术后辅助治疗的有效性。
纳入有或无增生性玻璃体视网膜病变（PVR）的RRD患者。治疗组包括使用类固醇作为辅助治疗的患者，对照组使用安慰剂。仅纳入随机对照试验。我们检索了主要电子数据库，并纳入截至2014年7月发表的研究。在三项试验中评估了PVR优势比、视力、视网膜复位率和并发症。
三项随机对照试验纳入了荟萃分析。两组术后PVR发生率无显著差异（异质性I² = 48%，P = 0.14）。然而，排除一项PVR C级研究后，治疗组术后PVR发生率低于对照组（I² = 0%，P < 0.0001）。治疗组和对照组术后视力无统计学显著差异（优势比 -0.18；95%置信区间 -0.38，0.02；P = 0.08）。两组在初次/最终视网膜复位和再次手术率方面结果相似。术后眼压无显著差异。
本系统评价表明，类固醇可显著降低RRD手术后B级或更低级别的术后PVR发生率。
