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联合筋膜鞘(CFS)悬吊术治疗上睑下垂的疗效与安全性:一项系统评价与Meta分析

Efficacy and Safety of Conjoint Fascial Sheath (CFS) Suspension in the Treatment of Blepharoptosis: A Systematic Review and Meta-analysis.

作者信息

Ji Dongshuo, Liu Ying, Han Xing, Hu Shouduo, Zhao Yanyong

机构信息

Plastic Surgery Department, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, 100038, China.

Ear Reconstruction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100144, China.

出版信息

Aesthetic Plast Surg. 2025 Feb 21. doi: 10.1007/s00266-025-04724-z.

Abstract

BACKGROUND

This study focuses on blepharoptosis, a common condition in oculoplastic surgery characterized by drooping of the upper eyelid. The efficacy and safety of using the combined fascial sheath (CFS) to correct blepharoptosis are still unclear.

METHODS

A systematic search encompassing four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to December 15, 2023, was conducted. The meta-analysis was performed using Stata 14.

RESULTS

A total of 10 studies involving 683 patients were included. The meta-analysis indicated a significant improvement in mean marginal reflex distance 1 (MRD1) in the CFS group compared to the control group (WMD: 2.33; 95% CI 1.61 to 3.06; I=97.2%, P < 0.001). Additionally, patient satisfaction in the CFS group was significantly higher than in the control group (OR: 5.28; 95% CI 1.71 to 16.32; I=0, P = 0.683), and the complication rate was significantly lower (OR 0.26; 95% CI 0.14 to 0.48; I=0, P = 0.899). However, no significant difference in curative effect was observed between the two groups (RD: 0.15; 95% CI -0.01 to 0.31; I=88.3%, P < 0.001).

CONCLUSION

CFS suspension has the potential to significantly improve MRD1 and patient satisfaction, while exhibiting a low incidence of complications and a favorable safety profile. These findings indicate that clinicians might consider CFS suspension as a viable treatment option for blepharoptosis. However, it is important to exercise caution due to inter-study heterogeneity and the limitations of current analysis.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

摘要

背景

本研究聚焦于上睑下垂,这是眼部整形手术中的一种常见病症,其特征为上睑下垂。使用联合筋膜鞘(CFS)矫正上睑下垂的疗效和安全性仍不明确。

方法

进行了一项系统检索,涵盖截至2023年12月15日的四个数据库(PubMed、Embase、Web of Science和Cochrane图书馆)。使用Stata 14进行荟萃分析。

结果

共纳入10项研究,涉及683例患者。荟萃分析表明,与对照组相比,CFS组的平均边缘反射距离1(MRD1)有显著改善(加权均数差:2.33;95%可信区间1.61至3.06;I² = 97.2%,P < 0.001)。此外,CFS组患者的满意度显著高于对照组(比值比:5.28;95%可信区间1.71至16.32;I² = 0,P = 0.683),并发症发生率显著更低(比值比0.26;95%可信区间0.14至0.48;I² = 0,P = 0.899)。然而,两组间疗效无显著差异(风险差:0.15;95%可信区间 -0.01至0.31;I² = 88.3%,P < 0.001)。

结论

CFS悬吊术有可能显著改善MRD1并提高患者满意度,同时并发症发生率低且安全性良好。这些发现表明临床医生可将CFS悬吊术视为上睑下垂的一种可行治疗选择。然而,鉴于研究间的异质性和当前分析的局限性,务必谨慎行事。

证据级别III:本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266。

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