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巩膜扣带术与气体视网膜固定术治疗孔源性视网膜脱离的比较

Scleral buckle versus pneumatic retinopexy for rhegmatogenous retinal detachments.

作者信息

Martínez-Mujica María-Teresa, Retamal José, González Raúl

机构信息

Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.

Proyecto Epistemonikos, Santiago, Chile; Departamento de Oftalmología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email:

出版信息

Medwave. 2018 Oct 5;18(6):e7278. doi: 10.5867/medwave.2018.06.7277.

DOI:10.5867/medwave.2018.06.7277
PMID:30339142
Abstract

INTRODUCTION

Rhegmatogenous retinal detachment is caused by a tear in the retina and is a frequent cause of vision loss. Its treatment is mainly surgical and the following alternatives can be identified: scleral buckling or classic surgery, pneumatic retinopexy and vitrectomy. Between the first two options, most professionals prefer scleral buckling over pneumatic retinopexy, but the latter is a simpler, cheaper and lower-risk procedure, so it is still considered as an option for selected patients. However, there is little evidence comparing both interventions.

METHODS

To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

RESULTS AND CONCLUSIONS

We identified three systematic reviews including six studies overall, of which three were randomized trials. We concluded the anatomic result might be better with scleral buckling in terms of retinal reattachment and risk of recurrence, but the risk of ocular adverse events might be lower with pneumatic retinopexy.

摘要

引言

孔源性视网膜脱离由视网膜裂孔引起,是视力丧失的常见原因。其治疗主要是手术治疗,可采用以下几种方法:巩膜扣带术或传统手术、气液交换术和玻璃体切除术。在前两种选择中,大多数专业人员更倾向于巩膜扣带术而非气液交换术,但气液交换术是一种更简单、更便宜且风险更低的手术,因此它仍被视为特定患者的一种选择。然而,比较这两种干预措施的证据很少。

方法

为回答这个问题,我们使用了Epistemonikos,这是健康领域最大的系统评价数据库,通过筛选多个信息来源(包括MEDLINE、EMBASE、Cochrane等)来维护。我们从系统评价中提取数据,重新分析原始研究的数据,进行荟萃分析,并使用GRADE方法生成结果总结表。

结果与结论

我们确定了三项系统评价,总共包括六项研究,其中三项是随机试验。我们得出结论,就视网膜复位和复发风险而言,巩膜扣带术的解剖学结果可能更好,但气液交换术的眼部不良事件风险可能更低。

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