Ting Darren Shu Jeng, Henein Christin, Said Dalia G, Dua Harminder S
1Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK 2Department of Ophthalmology, Queen Medical Centre, Nottingham, UK 3Newcastle University, Newcastle upon Tyne, UK 4National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
JBI Evid Synth. 2020 Aug;18(8):1808-1814. doi: 10.11124/JBISRIR-D-19-00367.
The objective of this review is to systematically examine the effectiveness of early adjuvant amniotic membrane transplant versus standard antimicrobial therapy for infectious keratitis.
Infectious keratitis is a major cause of corneal blindness worldwide. Broad-spectrum topical antimicrobial therapy is currently the gold standard for treatment. Amniotic membrane transplant has been employed as an adjuvant therapy to promote corneal healing; however, high-quality evidence is limited.
This review will consider studies that include patients of all ages with all types of infectious keratitis, including bacterial, fungal, viral, acanthamoeba, mixed, and culture-negative presumed infectious keratitis. The authors will exclude patients who have undergone other types of primary surgery other than amniotic membrane transplant during the initial management and those who had less than seven days' follow-up from the commencement of the treatment.
Electronic databases, including MEDLINE, Embase, Cochrane CENTRAL, and relevant registries, will be searched for pertinent studies. Titles, abstract, and full text of the relevant studies will be independently assessed by two reviewers. Extracted data will include authors, year of publication, sample size, types of amniotic membrane transplant techniques, types of causative microorganisms, main outcomes, visual acuity, and adverse events. No restriction will be applied to the date or language. Bibliographies of the included articles will be independently and manually screened by two authors to identify further relevant studies. Eligible studies will be critically appraised by two independent reviewers for methodological quality. A meta-analysis will be performed for the included randomized controlled trials when there are sufficient similarities.
This systematic review has been registered with PROSPERO (CRD42020175593).
本综述的目的是系统地研究早期辅助羊膜移植与标准抗菌治疗相比对感染性角膜炎的有效性。
感染性角膜炎是全球角膜盲的主要原因。广谱局部抗菌治疗是目前的治疗金标准。羊膜移植已被用作辅助治疗以促进角膜愈合；然而，高质量的证据有限。
本综述将纳入所有年龄段、所有类型感染性角膜炎患者的研究，包括细菌性、真菌性、病毒性、棘阿米巴性、混合性以及培养阴性疑似感染性角膜炎。作者将排除在初始治疗期间接受过除羊膜移植以外其他类型初次手术的患者以及治疗开始后随访时间少于7天的患者。
将检索电子数据库，包括MEDLINE、Embase、Cochrane CENTRAL及相关注册库，以查找相关研究。两名评审员将独立评估相关研究的标题、摘要和全文。提取的数据将包括作者、发表年份、样本量、羊膜移植技术类型、致病微生物类型、主要结局、视力和不良事件。对日期或语言不设限制。两名作者将独立人工筛选纳入文章的参考文献，以识别其他相关研究。两名独立评审员将对符合条件的研究进行方法学质量的严格评估。当纳入的随机对照试验有足够相似性时，将进行荟萃分析。
本系统评价已在PROSPERO注册（CRD42020175593）。
