在斑点孔手术后面向下定位或姿势
Olivia Cundy1, Clemens Ak Lange2,3, Catey Bunce4,5
1Ophthalmology , Imperial College Hospital, London, UK.
The Cochrane database of systematic reviews
|November 21, 2023
概括
在斑点孔手术后,术后面向下定位对孔关闭几乎没有影响. 这种低风险的干预措施可能不会显著改善大多数患者的结果,特别是那些有较小孔的患者.
科学领域:
- 眼科医生 眼科 眼科
- 外科手术的结果
- 视网膜外科手术 视网膜外科手术
背景情况:
- 斑点孔会导致明显的视力障碍,特别是较大的 (>400微米).
- 斑点孔的手术结果可以通过特定的术后方案来改善.
- 这一审查更新了2011年发表的关于面向下方定位的前科克伦研究结果.
研究的目的:
- 评估术后面向下定位对黄斑孔手术结果的影响.
- 评估对解剖孔关闭,视力敏,生活质量和不良事件的影响.
主要方法:
- 包括八项随机对照试验 (RCT),比较面向下定位与没有面向下定位.
- 在多个数据库 (CENTRAL,MEDLINE,Embase等) 进行了搜索. 截至 2022 年 5 月.
- 分析了二分法数据 (风险比率) 和连续数据 (平均差异) 的95%置信区间.
主要成果:
- 低确定性证据表明,向下定位对黄斑孔的闭合几乎没有影响 (RR 1.05,95% CI 0.99至1.12).
- 对于较大 (>400微米) 或较小 (<400微米) 的黄斑孔,没有观察到孔封闭的显著差异.
- 面向下定位是低风险的,严重的不良事件 (神经压缩) 影响了<1%的参与者.
结论:
- 术后面向下定位可能对黄斑孔的闭合几乎没有影响.
- 这种干预与不适有关,并没有显著改善视力敏度或生活质量.
- 未来的试验应侧重于更大的黄斑孔,采用标准化的干预措施和验证的结果措施.
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