Hecht Idan, Mimouni Michael, Blumenthal Eytan Z, Barak Yoreh
Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
J Ophthalmol. 2019 Mar 12;2019:1820850. doi: 10.1155/2019/1820850. eCollection 2019.
A systematic literature search was conducted to identify and review studies comparing SF to CF as a tamponade agent in the intraoperative management of macular holes.
Publications up to October 2018 that focused on macular hole surgery in terms of primary closure, complications, and clinical outcomes were included. Forest plots were created using a weighted summary of proportion meta-analysis. Analysis was performed separately for SF and CF. A random effects model was used, and corresponding heterogeneity estimates were calculated.
Nine pertinent publications studying a total of 4,715 patients were identified in 2000 to 2017, including two randomized studies (=206), two prospective studies (=170), and five retrospective or registry-based studies. Similar rates of closure between SF and CF were reported in eight out of nine studies, regardless of subgroup analyses. All studies reporting visual outcomes showed similar results when comparing SF to CF at one to six months of follow-up. Neither agent was clearly associated with increased risk of ocular hypertension, cataract formation, or other adverse events. Meta-analytic pooling of the closure rates in the SF group resulted in 91.73% (95% confidence interval: 88.40 to 94.55, : 38.03%), and for CF, the closure rate was 88.36% (95% confidence interval: 85.88 to 90.63, : 0.0%).
Both SF and CF appear to have achieved similar visual outcomes and primary closure rates and neither was associated with an increased risk of adverse events. Considering the more rapid visual recovery with SF, there appears to be no evidence to support CF as the tamponade agent of choice for macular hole surgery.
进行一项系统的文献检索，以识别和综述比较在黄斑裂孔术中作为填塞剂的硅油（SF）与气体（CF）的研究。
纳入截至2018年10月的出版物，这些出版物聚焦于黄斑裂孔手术的一期闭合、并发症及临床结局。采用比例Meta分析的加权汇总创建森林图。分别对SF和CF进行分析。使用随机效应模型，并计算相应的异质性估计值。
2000年至2017年共识别出9篇相关出版物，涉及4715例患者，包括2篇随机研究（n=206）、2篇前瞻性研究（n=170）以及5篇回顾性或基于登记的研究。9项研究中有8项报告称，无论亚组分析如何，SF和CF的闭合率相似。所有报告视觉结局的研究显示，在1至6个月的随访中将SF与CF进行比较时结果相似。两种药物均未明确与高眼压、白内障形成或其他不良事件风险增加相关。SF组闭合率的Meta分析合并结果为91.73%（95%置信区间：88.40至94.55，I²：38.03%），CF组的闭合率为88.36%（95%置信区间：85.88至90.63，I²：0.0%）。
SF和CF似乎都取得了相似的视觉结局和一期闭合率，且两者均与不良事件风险增加无关。考虑到SF能使视力恢复更快，似乎没有证据支持CF作为黄斑裂孔手术的首选填塞剂。
