Romano Vito, Cruciani Mario, Semeraro Francesco, Costagliola Ciro, Romano Mario R
Department of Ophthalmology, Second University of Naples, Naples, Italy; Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom, .
Indian J Ophthalmol. 2015 Mar;63(3):227-32. doi: 10.4103/0301-4738.156922.
The intraocular silicone oil (SO) tamponades used in the treatment of retinal detachment (RD) have been associated with a difference ocular hypertension (OH) rate. To clarify, if this complication was associated to use of standard SO (SSO) versus heavy SO (HSO), we performed a systematic review and meta-analysis of comparative study between two kind of SO (standard or light vs. heavy) for the treatment of RD and macular hole, without restriction to study design.
The methodological quality of two randomized clinical trials (RCTs) were evaluated using the criteria given in the Cochrane Handbook for Systematic Reviews of Intervention, while three non-RCTs were assessed with the Newcastle-Ottawa Scale and Strengthening the Reporting of Observational Studies in Epidemiology checklists. We calculated Mantel-Haenszel risk ratio (RR) with 95% confidence intervals (95% CIs). The primary outcome was the rate of patients with OH treated with SSO compared to HSO.
There were a higher number of rates of OH in HSO compared to SSO. This difference was statistically significant with the fixed effect model (Mantel-Haenszel RR; 1.55; 95% CI, 1.06-2.28; P = 0.02) while there was not significative difference with the random effect model (Mantel-Haenszel RR; 1.51; 95% CI, 0.98-2.33; P = 0.06).
We noted a trend that points out a higher OH rate in HSO group compared to SSO, but this finding, due to the small size and variable design of studies, needs to be confirmed in well-designed and large size RCTs.
用于治疗视网膜脱离(RD)的眼内硅油(SO)填塞与不同的高眼压(OH)发生率相关。为了明确这种并发症是否与标准SO(SSO)和重SO(HSO)的使用有关,我们对两种SO(标准或轻质与重质)治疗RD和黄斑裂孔的比较研究进行了系统评价和荟萃分析,研究设计不限。
使用《Cochrane干预性系统评价手册》中给出的标准评估两项随机临床试验(RCT)的方法学质量,同时使用纽卡斯尔-渥太华量表和加强流行病学观察性研究报告清单评估三项非RCT。我们计算了Mantel-Haenszel风险比(RR)及95%置信区间(95%CI)。主要结局是接受SSO治疗的患者与接受HSO治疗的患者发生OH的比率。
与SSO相比,HSO的OH发生率更高。固定效应模型显示这种差异具有统计学意义(Mantel-Haenszel RR;1.55;95%CI,1.06 - 2.28;P = 0.02),而随机效应模型则无显著差异(Mantel-Haenszel RR;1.51;95%CI,0.98 - 2.33;P = 0.06)。
我们注意到一种趋势,即HSO组的OH发生率高于SSO组,但由于研究规模小且设计多样,这一发现需要在设计良好的大样本RCT中得到证实。