Department of Ophthalmology, 199193Affiliated Hospital of Jiangnan University, Wuxi, China.
Department of Otolaryngology - Head and Neck Surgery, 199193Affiliated Hospital of Jiangnan University, Wuxi, China.
Am J Rhinol Allergy. 2023 Jan;37(1):102-109. doi: 10.1177/19458924221126356. Epub 2022 Sep 13.
The aim of this meta-analysis is to compare the surgical results of endoscopic dacryocystorhinostomy (Endo-DCR) for chronic dacryocystitis (CD) with and without intraoperative hyaluronic acid (HA) application.
An electronic literature search was performed using the PubMed, Embase, Cochrane Library, CNKI, and Wan Fang databases in April 1, 2022. Review Manager software version 5.4 was used for data synthesis and a forest plot was generated for each outcome measure.
Seven randomized control trials (RCTs), which involved 739 eyes, were included in this meta-analysis. Overall, compared with the control group, intraoperative HA application significantly enhance the success rate (odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.15-4.98, < .00001), promote re-epithelization (OR = 2.93, 95% CI: 1.83-4.68, < .00001), reduce granulation (OR = 0.41, 95% CI: 0.21-0.80, = .008), and scar (OR = 0.39, 95% CI: 0.22-0.68, = .001) formation after Endo-DCR.
Intraoperative HA application seems to be a useful adjuvant that could enhance success rate by promoting re-epithelization and inhabiting granulation and scar formation around the ostium.
本荟萃分析旨在比较内镜鼻内泪囊吻合术（Endo-DCR）治疗慢性泪囊炎（CD）时术中应用透明质酸（HA）与不应用 HA 的手术结果。
于 2022 年 4 月 1 日，通过电子文献检索 PubMed、Embase、Cochrane Library、CNKI 和万方数据库，使用 Review Manager 软件版本 5.4 进行数据综合，并为每个结局指标生成森林图。
纳入本荟萃分析的 7 项随机对照试验（RCT）共涉及 739 只眼。总体而言，与对照组相比，术中应用 HA 可显著提高成功率（比值比 [OR] = 3.27，95%置信区间 [CI]：2.15-4.98，< .00001），促进再上皮化（OR = 2.93，95% CI：1.83-4.68，< .00001），减少肉芽组织（OR = 0.41，95% CI：0.21-0.80， = .008）和瘢痕（OR = 0.39，95% CI：0.22-0.68， = .001）形成。
术中应用 HA 似乎是一种有用的辅助手段，可通过促进再上皮化和抑制吻合口周围的肉芽组织和瘢痕形成来提高成功率。
