Oliva Oscar, Morgado Álvaro
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:
Medwave. 2018 Oct 29;18(6):e7319. doi: 10.5867/medwave.2018.06.7318.
Intermittent exotropia requires surgical resolution under some clinical circumstances. The main techniques are bilateral lateral rectus recession and unilateral recess/resection. Although bilateral recession is the most widely used, it is not clear whether it leads to better results.
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.
We identified five systematic reviews including seven studies overall, of which three were randomized trials. We concluded unilateral recess/resection might achieve greater surgical success and probably decrease the rate of undercorrection/recurrence when compared to bilateral lateral rectus recession.
在某些临床情况下，间歇性外斜视需要手术治疗。主要技术是双侧外直肌后徙术和单侧后徙/切除术。虽然双侧后徙术是最常用的，但尚不清楚它是否能带来更好的效果。
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）进行维护。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。
我们确定了五项系统评价，总共包括七项研究，其中三项是随机试验。我们得出结论，与双侧外直肌后徙术相比，单侧后徙/切除术可能取得更大的手术成功率，并且可能降低矫正不足/复发率。
