Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, PR China.
Department of Ophthalmology, University of South Florida, Tampa, FL, USA.
Eye (Lond). 2022 Mar;36(3):619-626. doi: 10.1038/s41433-021-01474-5. Epub 2021 Apr 6.
To evaluate the efficacy of intravitreal conbercept (IVC) in pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR).
A meta-analysis of randomized control trials (RCTs) using online databases was performed. The intraoperative outcome measures were the incidence of intraoperative bleeding and endodiathermy application, and the mean surgical time. The postoperative outcome measures were mean change in best-corrected visual acuity (BCVA) from baseline, postoperative vitreous clear-up time and incidence of recurrent vitreous hemorrhage (VH).
Eight RCTs were selected for meta-analysis. They included 409 eyes (215 eyes in IVC group and 194 eyes in no conbercept group). Preoperative IVC application was associated with less intraoperative bleeding and endodiathermy applications (RR = 0.34, 95% CI, 0.23-0.50, P < 0.00001, and RR = 0.26, 95% CI, 0.12-0.56, P = 0.0005) compared to no conbercept. It also shortened surgical time (WMD = -15.87, 95% CI, -22.04 to -9.69, P < 0.00001). In addition, preoperative or intraoperative IVC achieved better BCVA outcome (WMD = -0.37, 95% CI, -0.62 to -0.13, P = 0.003), shorter vitreous clear-up time postoperatively (WMD = -5.44, 95% CI, -6.31 to -4.57, P < 0.00001) and a lower rate of VH recurrence (RR = 0.45, 95% CI, 0.22-0.91, P = 0.03).
IVC is an effective adjuvant in PPV for PDR, with better intraoperative and postoperative outcomes.
评估玻璃体内注射康柏西普(IVC)联合玻璃体切割术(PPV)治疗增生型糖尿病视网膜病变(PDR)的疗效。
通过在线数据库进行荟萃分析,纳入随机对照试验(RCT)。术中结局指标包括术中出血和内电凝应用的发生率,以及平均手术时间。术后结局指标包括从基线开始最佳矫正视力(BCVA)的平均变化,术后玻璃体内清除时间和复发性玻璃体积血(VH)的发生率。
共纳入 8 项 RCT 进行荟萃分析,共纳入 409 只眼(IVC 组 215 只眼,无康柏西普组 194 只眼)。与无康柏西普相比,术前应用 IVC 可减少术中出血(RR=0.34,95%CI,0.23-0.50,P<0.00001)和内电凝应用(RR=0.26,95%CI,0.12-0.56,P=0.0005)。IVC 还缩短了手术时间(WMD=-15.87,95%CI,-22.04 至-9.69,P<0.00001)。此外,术前或术中应用 IVC 可获得更好的 BCVA 结局(WMD=-0.37,95%CI,-0.62 至-0.13,P=0.003),术后玻璃体清除时间更短(WMD=-5.44,95%CI,-6.31 至-4.57,P<0.00001),VH 复发率更低(RR=0.45,95%CI,0.22-0.91,P=0.03)。
IVC 是治疗 PDR 的一种有效的辅助治疗方法,具有更好的术中及术后效果。