经皮穿刺抽吸和注药术与标准经睫状体平坦部玻璃体切除术治疗眼内炎的疗效比较：Meta 分析。

TAP AND INJECT VERSUS PARS PLANA VITRECTOMY FOR POSTPROCEDURAL ENDOPHTHALMITIS: A Meta-analysis.

机构信息

Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada.

Department of Ophthalmology and Vision Sciences, the University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Retina. 2021 Oct 1;41(10):2009-2016. doi: 10.1097/IAE.0000000000003203.

DOI:10.1097/IAE.0000000000003203

PMID:34009185

Abstract

PURPOSE

To compare the visual outcomes after prompt pars plana vitrectomy (PPV) with tap biopsy and intravitreal antimicrobial injection to treat postinjection and postsurgery endophthalmitis.

METHODS

The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Ovid Embase databases were searched for articles published between January 2010 and November 2020. Two independent reviewers selected articles and extracted data. We analyzed data in RevMan 5.3 and assessed methodological quality using the Cochrane ROBINS-I tool. The mean improvement in visual outcome was compared between PPV and intravitreal antimicrobial injection as a relative risk of improving ≥2 lines and a mean logarithm of the minimal angle of resolution difference in improvement.

RESULTS

Fifteen retrospective case series (1,355 eyes), of which 739 eyes (55%) received intravitreal antimicrobial injection and 616 (45%) received PPV as initial treatment, were included. The overall relative risk of improving 2 or more lines in PPV in comparison with intravitreal antimicrobial injection was 1.04 (95% CI 0.88-1.23; P = 0.61; I2 = 0%) with a mean difference of 0.04 (95% CI -0.18 to 0.27; P = 0.69; I2 = 0%). The results stayed robust when subgroup analysis based on causative procedure for endophthalmitis was performed.

CONCLUSION

Intravitreal antimicrobial injection is noninferior to PPV for the treatment of postcataract operation, postinjection, and post-PPV endophthalmitis.

摘要

目的

比较及时行玻璃体切除术（PPV）联合经巩膜穿刺活检与玻璃体内注射抗菌药物治疗眼内炎的临床疗效。

方法

检索 Cochrane 对照试验中心注册库、Ovid MEDLINE 和 Ovid Embase 数据库，检索时间从 2010 年 1 月至 2020 年 11 月，纳入关于玻璃体切除术联合经巩膜穿刺活检与玻璃体内注射抗菌药物治疗眼内炎的随机对照试验。由 2 位独立的评价员筛选文献、提取数据，使用 RevMan 5.3 软件进行数据分析，并采用 Cochrane ROBINS-I 工具评价方法学质量。采用相对危险度比较 PPV 与玻璃体内注射抗菌药物治疗眼内炎后视力改善≥2 行的比例，采用均数差值比较改善的最小分辨角对数(logMAR)差值。

结果

共纳入 15 项回顾性病例系列研究（1355 只眼），其中 739 只眼（55%）接受玻璃体内注射抗菌药物治疗，616 只眼（45%）接受 PPV 治疗。与玻璃体内注射抗菌药物治疗相比，PPV 治疗眼内炎后视力改善≥2 行的相对危险度为 1.04（95% CI 0.88~~1.23；P = 0.61；I2 = 0%），差异无统计学意义，均数差值为 0.04（95% CI -0.18~~0.27；P = 0.69；I2 = 0%）。按眼内炎病因不同进行亚组分析，结果仍稳健。