Department of Ophthalmology, University Hospital Center of São João, Porto, Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
Ocul Immunol Inflamm. 2022 Jan 2;30(1):215-222. doi: 10.1080/09273948.2020.1787463. Epub 2020 Aug 18.
BACKGROUND/AIMS: To compare different existent implants for noninfectious uveitis.
We performed a systematic review of randomized clinical trials (RCTs), searching in five electronic databases and screening reference lists of included studies and relevant reviews. We performed network meta-analysis to compare 0.18 mg fluocinolone acetonide implants, 0.70 mg and 0.35 mg dexamethasone implants, and sham procedures.
Eight RCTs were included in this systematic review, of which three articles from two studies (n = 358 patients) were included in network meta-analysis. The 0.70 mg dexamethasone implant (at 1.5 months) was associated with better results than the 0.18 mg fluocinolone acetonide implant (at 1 month) at improving vitreous haze grading (RR = 2.96; 95%CI = 1.23-7.07), and with less frequently development of cataracts at 12 (RR = 0.36; 95%CI = 0.17; 0.79) and 36 months (RR = 0.37; 95%CI = 0.20; 0.71).
In the short term, the 0.70 mg dexamethasone implant is superior at improving vitreous haze, and shows lower risk of cataracts. However, additional RCTs with standardized outcomes are needed.
背景/目的：比较非感染性葡萄膜炎中不同现有植入物的效果。
我们对随机对照试验（RCT）进行了系统评价，在五个电子数据库中进行了检索，并筛选了纳入研究和相关综述的参考文献列表。我们进行了网络荟萃分析，比较了 0.18mg 氟轻松丙酮缩酮植入物、0.70mg 和 0.35mg 地塞米松植入物与假手术。
这项系统评价纳入了 8 项 RCT，其中 3 项来自 2 项研究的文章（n=358 名患者）纳入了网络荟萃分析。与 0.18mg 氟轻松丙酮缩酮植入物（1 个月）相比，0.70mg 地塞米松植入物（1.5 个月）在改善玻璃体混浊分级方面效果更好（RR=2.96；95%CI=1.23-7.07），在 12（RR=0.36；95%CI=0.17；0.79）和 36 个月（RR=0.37；95%CI=0.20；0.71）时发生白内障的风险较低。
在短期内，0.70mg 地塞米松植入物在改善玻璃体混浊方面更优，且白内障风险较低。然而，仍需要更多具有标准化结局的 RCT。
