Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis.
Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis.
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类固醇作为降低孔源性视网膜脱离手术后增殖性玻璃体视网膜病变发生率的辅助手段：系统评价和荟萃分析
DOI：
10.2147/dddt.s80983
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Yu J
中科院分区：
文献类型：
--
作者：
Shi H;Guo T;Liu PC;Wang QY;Du YR;Liu QY;He MM;Liu JL;Yu J
本荟萃分析旨在确定类固醇作为孔源性视网膜脱离（RRD）手术后辅助治疗的有效性。方法RRD患者分为增生性玻璃体视网膜病变（PVR）组和非增生性玻璃体视网膜病变（PVR）组。治疗组包括使用类固醇作为辅助治疗的患者和使用安慰剂的对照组。仅纳入随机对照试验。我们检索了主要的电子数据库，并纳入了截至2014年7月发表的研究。在三项试验中评价了PVR比值比、视力、视网膜复位率和并发症。结果纳入3篇随机对照试验。两组术后PVR发生率无显著差异（异质性I2= 48%，P=0.14）。然而，当排除C级PVR研究时，治疗组的术后PVR发生率（I2= 0%，P<0.0001）低于对照组。治疗组和对照组的术后视力无统计学显著差异（比值比-0.18; 95%置信区间-0.38，0.02; P=0.08）。两组在初次/最终视网膜复位和再手术率方面的结果相似。术后眼压无显著差异。结论本系统评价表明，类固醇可显著降低RRD术后PVR B级或更低级别的发生率。
Background This meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD) surgery. Methods RRD patients with or without proliferative vitreoretinopathy (PVR) were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials. Results Three randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I2=48%, P=0.14). However, the incidence of postoperative PVR was lower in the treatment group (I2=0%, P<0.0001) than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio −0.18; 95% confidence interval −0.38, 0.02; P=0.08). The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure. Conclusion This systematic review demonstrates that steroids may significantly reduce the incidence of postoperative PVR grade B or lower following RRD surgery.