Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.
Ophthalmic Res. 2023;66(1):767-776. doi: 10.1159/000530232. Epub 2023 Mar 27.
Air tamponade's effectiveness in treatment of rhegmatogenous retinal detachment (RRD) remains unclear.
We aimed to review the surgical outcomes between air and gas tamponade after vitrectomy for RRD.
PubMed, Cochrane Library, EMBASE, and Web of Science were reviewed. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022342284). The primary outcome was the primary anatomical success after vitrectomy. The secondary outcome was the prevalence of postoperative ocular hypertension. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system.
Ten studies involving 2,677 eyes were included. One study was randomized, and the others were non-randomized. The primary anatomical success after vitrectomy was not significantly different between the air and gas groups (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.68-1.48). The risk of ocular hypertension was significantly lower in the air group (OR: 0.14; 95% CI: 0.09-0.24). The certainty of evidence regarding air tamponade having a comparable anatomical outcome and lower frequency of postoperative ocular hypertension in treatment of RRD were low.
The current evidence base for tamponade selection in treatment of RRD has several major limitations. Further appropriately designed studies are needed to guide tamponade selection.
空气填充在治疗孔源性视网膜脱离（RRD）中的效果尚不清楚。
我们旨在比较玻璃体切除术后空气填充和气体填充治疗 RRD 的手术效果。
检索 PubMed、Cochrane Library、EMBASE 和 Web of Science。研究方案已在国际前瞻性系统评价注册平台（PROSPERO CRD42022342284）注册。主要结局是玻璃体切除术后的初次解剖学成功。次要结局是术后高眼压的发生率。使用推荐评估、制定与评价系统（Grading of Recommendations Assessment, Development, and Evaluation，GRADE）评估证据的确定性。
纳入 10 项研究共 2677 只眼。其中 1 项为随机研究，其余为非随机研究。玻璃体切除术后的初次解剖学成功在空气组和气体组之间无显著差异（比值比 [OR]，1.00；95%置信区间 [CI]，0.68-1.48）。空气组的高眼压风险显著降低（OR：0.14；95% CI：0.09-0.24）。关于空气填充在治疗 RRD 中具有相似的解剖学结果和较低的术后高眼压发生率的证据确定性较低。
治疗 RRD 时选择填塞物的现有证据基础存在几个主要局限性。需要进一步设计合理的研究来指导填塞物的选择。
