Ouyang Xiao-Wei, Fang Sheng, Yi Yun-Min, Zou Shi-Peng, Hu Qi-Yu, Huang Zi-Xuan, Li Qing-Xia, Luo Jin-Yan
Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China.
Department of Ophthalmology, Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine, Nanchang 330000, Jiangxi Province, China.
Int J Ophthalmol. 2024 Jun 18;17(6):1110-1119. doi: 10.18240/ijo.2024.06.17. eCollection 2024.
To compare high or low concentration of hyaluronic acid eye drops (HY) for dry eye syndromes (DES).
Randomized controlled trials (RCTs) comparing various concentrations of HY were searched in PubMed, Embase, Web of Science, Cochrane, SinoMed, CNKI, Wanfang Database, CQVIP, and Chinese journals databases between inception and July 2023. Pooled standardized mean differences (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CI) from RCTs evaluating Schirmer's I test (SIT), corneal fluorescein staining score (CFS), tear breakup time (TBUT), DES score (DESS), and Ocular Surface Disease Index (OSDI) were calculated. Sensitivity analysis, Egger's test and Meta-regression analysis were performed for all indicators.
We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria, involving 1796 cases. High-concentrations group significantly improved the outcome of CFS according to random effects modelling (SMD, -3.37; 95%CI, -5.25 to -1.48; =0.0005). The rest of the results were not statistically significant, including indicators such as SIT, TBUT, DESS and OSDI.
For dry eyes with positive corneal staining, a high concentration of HY is recommended, whereas in other cases, a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.
比较高浓度和低浓度透明质酸钠滴眼液（HY）治疗干眼综合征（DES）的效果。
检索了PubMed、Embase、Web of Science、Cochrane、中国生物医学文献数据库、中国知网、万方数据库、维普资讯和中文期刊数据库，纳入自建库至2023年7月期间比较不同浓度HY的随机对照试验（RCT）。计算评估泪液分泌试验I（SIT）、角膜荧光素染色评分（CFS）、泪膜破裂时间（TBUT）、干眼综合征评分（DESS）和眼表疾病指数（OSDI）的RCT的合并标准化均数差（SMD）或加权均数差（WMD）及95%置信区间（CI）。对所有指标进行敏感性分析、Egger检验和Meta回归分析。
我们对10项符合纳入标准的RCT进行了Meta分析，共纳入1796例患者。根据随机效应模型，高浓度组在改善CFS结果方面有显著差异（SMD，-3.37；95%CI，-5.25至-1.48；P=0.0005）。其余结果无统计学意义，包括SIT、TBUT、DESS和OSDI等指标。
对于角膜染色阳性的干眼患者，推荐使用高浓度的HY，而在其他情况下，高浓度HY在治疗干眼方面并不比低浓度HY具有更明显的优势。
