Vazquez-Ferreiro Pedro, Carrera-Hueso Francisco J, Barreiro-Rodriguez Lidia, Diaz-Rey Marta, Poquet-Jornet Jaime E, Ramón-Barrios María Auxiliadora, Sanjuan-Cerveró Rafael
1 Ophthalmologic Department, Hospital Virxen da Xunqueira , Cee, A Coruña, Spain .
2 Social Pharmacy Department, University of Granada , Granada, Spain .
J Ocul Pharmacol Ther. 2017 Dec;33(10):735-742. doi: 10.1089/jop.2017.0084. Epub 2017 Nov 3.
To compare the effectiveness of intracameral phenylephrine and topical mydriatics in achieving mydriasis and protecting against complications during phacoemulsification.
A systematic search of the literature comparing the mydriatic effect and surgical safety profile of intracameral phenylephrine and topical mydriatics in phacoemulsification was conducted in the Medline, Embase, Lilacs, Web of Science, Cochrane, ClinicalTrials.gov , and Teseo databases. The search targeted clinical trials, cohort studies, and case-control studies published between April 20, 2003 and August 14, 2016. Mydriatic effect was assessed by difference in means in pupil of all the patients in the studies [mean difference (MD)] and intraoperative complications were assessed by using inverse-variance weighted odds ratios (ORs), with adjustment for dose. A meta-regression analysis was also conducted, with adjustment for dose, use of epinephrine, tamsulosin use, and type of surgery and type of intraocular lens.
We found 7 articles about mydriatic effect and another 7 about complications. Intracameral phenylephrine achieved a similar mydriatic effect to topical mydriatics, with a difference of less than 10% (MD -0.74 mm, 95% CI: -1.67 to 0.18, I = 95.8%, P < 0.0001). The pooled OR for complications was OR 0.50, 95% CI: 0.19-1.31, I = 0.0%, P = 0.670, and posterior capsular rupture was the most common complication in the different studies analyzed.
Intracameral phenylephrine achieves a similar mydriatic effect to topical mydriatics (difference <15%) and is associated with a not-significant effect on reducing the odds of intraoperative complications.
比较前房内注射去氧肾上腺素与局部使用散瞳剂在白内障超声乳化术中散瞳效果及预防并发症方面的有效性。
在Medline、Embase、Lilacs、科学网、Cochrane、ClinicalTrials.gov和Teseo数据库中系统检索比较前房内注射去氧肾上腺素与局部使用散瞳剂在白内障超声乳化术中散瞳效果和手术安全性的文献。检索范围为2003年4月20日至2016年8月14日发表的临床试验、队列研究和病例对照研究。通过研究中所有患者瞳孔均值差异[平均差(MD)]评估散瞳效果，采用逆方差加权比值比(OR)评估术中并发症，并对剂量进行校正。还进行了荟萃回归分析，对剂量、肾上腺素使用、坦索罗辛使用、手术类型和人工晶状体类型进行校正。
我们找到7篇关于散瞳效果的文章以及另外7篇关于并发症的文章。前房内注射去氧肾上腺素与局部使用散瞳剂的散瞳效果相似，差异小于10%(MD -0.74 mm，95%CI：-1.67至0.18，I=95.8%，P<0.0001)。并发症的合并OR为0.50，95%CI：0.19 - 1.31，I=0.0%，P=0.670，后囊膜破裂是所分析的不同研究中最常见的并发症。
前房内注射去氧肾上腺素与局部使用散瞳剂的散瞳效果相似(差异<15%)，且对降低术中并发症发生率的影响不显著。
