Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu Province, China.
Graefes Arch Clin Exp Ophthalmol. 2022 Jul;260(7):2095-2101. doi: 10.1007/s00417-022-05589-7. Epub 2022 Feb 18.
To compare the outcomes of medial rectus plication and medial rectus resection procedures in the treatment of exotropia.
Articles from Pubmed, EMBASE, Web of Science, and Cochrane Library databases until July 2021 with a minimum follow-up period of 1 month were retrieved. No restriction on language was applied. Eligible studies must comply with the inclusion criteria. Only studies with comparisons between unilateral medial rectus plication versus unilateral medial rectus resection, unilateral lateral rectus recession-medial rectus plication (RP) versus unilateral lateral rectus recession-medial rectus resection (RR), or bilateral medial rectus plication(BMRP) versus bilateral medial rectus resection (BMRR) would be included for subsequent analysis. Two primary outcomes were specified: success rate and mean postoperative deviation. Dichotomous data were calculated as pooled odds ratios (ORs) with 95% confidence intervals (CIs) and continuous data as weighted mean differences (WMD) with 95% CIs.
A total of 8 studies with 557 participants were enrolled in the meta-analysis based on the inclusion criteria. Seven studies compared lateral rectus recession + medial rectus plication to unilateral lateral rectus recession + medial rectus resection and one study compared bilateral medial rectus plication to bilateral medial rectus resection. Differences in success rates between plication and resection groups were not statistically significant (OR = 0.66; 95% CI, 0.43-1.02; P = 0.06), and the unsatisfactory effects (the undercorrection and overcorrection rates) between the two groups were comparable. Additionally, there were also no significant differences in postoperative deviation and the amount of exodrift between the two groups.
This meta-analysis provides evidence that both the medial rectus plication and medial rectus resection procedures have similar efficacy in the treatment of exotropia.
比较内直肌缩短术和内直肌切除术治疗外斜视的疗效。
检索 2021 年 7 月前在 Pubmed、EMBASE、Web of Science 和 Cochrane Library 数据库中发表的文章，随访时间至少 1 个月，不限制语言。纳入的研究必须符合纳入标准。仅纳入单侧内直肌缩短术与单侧内直肌切除术、单侧外直肌后退-内直肌缩短术（RP）与单侧外直肌后退-内直肌切除术（RR）或双侧内直肌缩短术（BMRP）与双侧内直肌切除术（BMRR）比较的研究进行后续分析。指定了两个主要结局：成功率和平均术后偏斜度。二分类数据计算为合并优势比（OR）及其 95%置信区间（CI），连续数据计算为加权均数差（WMD）及其 95%CI。
根据纳入标准，共有 8 项研究、557 名参与者纳入荟萃分析。7 项研究比较了外直肌后退+内直肌缩短术与单侧外直肌后退+内直肌切除术，1 项研究比较了双侧内直肌缩短术与双侧内直肌切除术。缩短组和切除术组的成功率差异无统计学意义（OR=0.66；95%CI，0.43-1.02；P=0.06），两组的不满意效果（欠矫和过矫率）相当。此外，两组术后偏斜度和外飘量也无显著差异。
这项荟萃分析提供的证据表明，内直肌缩短术和内直肌切除术治疗外斜视的疗效相似。
