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选择性激光小梁成形术后抗炎治疗:系统评价文献和随机对照试验荟萃分析。

Anti-inflammatory treatment after selective laser trabeculoplasty: a systematic review of the literature and meta-analysis of randomized control trials.

机构信息

School of Medicine, University of Thessaly, Larissa, Greece.

Department of Ophthalmology, General Hospital of Trikala, Trikala, Greece.

出版信息

Arq Bras Oftalmol. 2023 Oct 9;86(5):e20210353. doi: 10.5935/0004-2749.2021-0353. eCollection 2023.

Abstract

We assessed the effects of anti-inflammatory treatment after selective laser trabeculoplasty through a systematic search of the MEDLINE, COCHRANE, and ClinicalTrials.gov. The outcome measures were intraocular pressure, anterior chamber inflammation, and discomfort. Evidence synthesis was performed using fixed effects or random-effects model according to the heterogeneity of the included studies. Heterogeneity was assessed using Q-statistic and I2. For an overall estimate of continuous outcomes, the mean differences and their 95% confidence intervals were applied, while odds ratios and their 95% confidence intervals were applied for dichotomous outcomes. Six studies were included in all. No significant difference was noted in the patients for intraocular pressure and discomfort when treated with anti-inflammatory drops. However, the patients showed benefit from reduced anterior chamber inflammation in the first postoperative week [FE OR=0.43, 95% CI=(0.19, 0.95), PQ=0.97, I2=0%], with no significant difference between the outcomes of non-steroidal anti-inflammatory drugs and steroids [FE OR=0.75, 95% CI=(0.20, 2.82), PQ=0.37, I2=0%]. Anti-inflammatory drops reduce anterior chamber inflammation after selective laser trabeculoplasty but showed no effect on the intraocular pressure.

摘要

我们通过系统检索 MEDLINE、COCHRANE 和 ClinicalTrials.gov,评估了抗炎治疗对选择性激光小梁成形术的影响。结局指标为眼压、前房炎症和不适。根据纳入研究的异质性,采用固定效应或随机效应模型进行证据综合。使用 Q 统计量和 I2 评估异质性。对于连续结局的总体估计,应用了均数差及其 95%置信区间,而对于二分类结局,则应用了比值比及其 95%置信区间。所有研究共纳入 6 项研究。应用抗炎滴眼剂治疗后,患者的眼压和不适无显著差异。然而,患者在前术后第 1 周表现出前房炎症减轻的益处[FE OR=0.43,95%CI=(0.19,0.95),PQ=0.97,I2=0%],非甾体抗炎药和类固醇的结局之间无显著差异[FE OR=0.75,95%CI=(0.20,2.82),PQ=0.37,I2=0%]。抗炎滴眼剂可减轻选择性激光小梁成形术后的前房炎症,但对眼压无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5289/11826534/a794ee7c9289/abo-86-05-e2023-0353-g01.jpg

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