一个随机对照试验的辅助三氨醇乙化物在眼睛接受视网膜外科手术的眼睛开放球创伤 - ASCOT研究ASCOT研究
David G Charteris1, Suzie Cro2, Edward Casswell1
1Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Health technology assessment (Winchester, England)
|October 16, 2023
概括
辅助的三氨乙化物并没有改善视力敏度的结果,开放的全球创伤患者接受了玻璃切除术. 该研究没有发现任何好处,并建议视网膜重新连接的潜在危害,建议不要使用它.
科学领域:
- 眼科医生 眼科 眼科
- 创伤外科 手术 创伤外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 开放地球创伤带来高视力损伤的风险,增殖性玻璃视网膜病变是视力丧失的常见原因.
- 之前的研究表明,辅助类固醇药物,三氨乙化物,可能会减少增殖性玻璃色素变异症,并改善眼部创伤的外科手术结果.
研究的目的:
- 为了研究在开放球创伤的视网膜外科手术中辅助氨乙酸的临床有效性.
- 评估氨酸对视觉敏度,视网膜重新连接和眼睛创伤手术后的生活质量的影响.
主要方法:
- 一个第三阶段的多中心,双面罩,随机对照试验 (ASCOT研究),涉及为开放地球创伤进行玻璃切除术的患者.
- 患者被随机分配,接受辅助的三氨醇乙化物 (眼内和子) 或标准护理.
- 主要结局是六个月后视力敏度的改善;次要结局包括视网膜重新连接和生活质量测量.
主要成果:
- 对于Triamcinolone Acetonide,没有观察到明显的治疗益处,主要结果是改善视力敏度.
- 其次性结局也未能显示出治疗的益处;稳定的视网膜和黄斑重新连接的结局在三素乙胺组中更糟糕.
- 卫生经济学分析显示,两组人群在质量调整后的寿命年数中没有显著差异.
结论:
- 结合眼内和sub-Tenon的triamcinolone乙化物不建议作为眼内创伤的玻璃切除术的辅助.
- 这项研究表明,对二次结果的潜在负面影响,尽管治疗组的初始病理情况更严重,但需要谨慎.
- 未来的研究应该探索替代辅助药物,并完善临床分级,以便在开放的全球创伤中更好地设计试验.
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