Flynn C A, D'Amico F, Smith G
Medical College of Wisconsin, Waukesha, USA.
J Fam Pract. 1998 Oct;47(4):264-70.
Eye patching is commonly recommended for treating corneal abrasions. This advice seems based more on anecdotes or disease-oriented evidence theorizing that there is faster healing or less pain when the eye is patched. This meta-analysis was performed to determine if eye patching is a useful treatment for corneal abrasions.
We conducted a comprehensive search of both MEDLINE (1966 to 1997) and Science Citation Index to locate relevant articles. We reviewed the bibliographies of included studies, and ophthalmology and primary care texts. Local ophthalmologists and authors were contacted to identify any unpublished data. Controlled trials that evaluated eye patching compared with no patching in patients older than 6 years with uncomplicated corneal abrasions were considered. The outcomes of interest were healing rates and degree of pain.
Seven trials were identified for inclusion, of which five could be statistically combined. Healing rates were similar in the two groups. The summary ratios (95% confidence interval) of healing rates in the patch group as compared with the no-patch group were 0.87 (0.68 to 1.13) and 0.90 (0.75 to 1.10) at days 1 and 2, respectively. Six studies evaluated pain: four found no difference and two favored not patching. No differences in complication rates were noted between the patched and nonpatched groups.
Eye patching was not found to improve healing rates or reduce pain in patients with corneal abrasions. Given the theoretical harm of loss of binocular vision and possible increased pain, we recommend the route of harmless nonintervention in treating corneal abrasions.
眼部包扎通常被推荐用于治疗角膜擦伤。这一建议似乎更多基于轶事或针对疾病的证据，推测眼部包扎时愈合更快或疼痛更少。本荟萃分析旨在确定眼部包扎是否是治疗角膜擦伤的有效方法。
我们对MEDLINE（1966年至1997年）和科学引文索引进行了全面检索，以查找相关文章。我们查阅了纳入研究的参考文献以及眼科和初级保健教材。联系了当地眼科医生和作者以确定任何未发表的数据。纳入的研究为针对6岁以上单纯性角膜擦伤患者比较眼部包扎与不包扎的对照试验。感兴趣的结果是愈合率和疼痛程度。
确定纳入7项试验，其中5项可进行统计学合并。两组的愈合率相似。包扎组与未包扎组在第1天和第2天的愈合率汇总比值（95%置信区间）分别为0.87（0.68至1.13）和0.90（0.75至1.10）。6项研究评估了疼痛：4项未发现差异，2项支持不包扎。包扎组和未包扎组之间并发症发生率无差异。
未发现眼部包扎能提高角膜擦伤患者的愈合率或减轻疼痛。鉴于双眼视觉丧失的理论危害以及可能增加的疼痛，我们建议在治疗角膜擦伤时采用无害的非干预方法。
