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早期与延迟的玻璃切除术对开放球损伤:一个系统的审查和元分析

Miguel A Quiroz-Reyes¹, Erick A Quiroz-Gonzalez², Miguel A Quiroz-Gonzalez²

¹Retina Department. Oftalmologia Integral ABC, Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Mexico City, Mexico.

Clinical ophthalmology (Auckland, N.Z.)

|July 2, 2024

概括

开放球损伤的早期玻璃切除术显著改善视觉结果和视网膜重新连接率,同时降低了增殖性玻璃视网膜病变 (PVR) 的发生率. 这种迅速的干预对于更好的患者预后至关重要.

科学领域:

眼科医生眼科眼科
创伤外科手术创伤外科

背景情况:

开放球损伤 (OGIs) 是全球单眼失明的主要原因.
及时治疗对于预防诸如增殖性玻璃色素病变 (PVR) 和内炎等并发症至关重要.
目前的OGI管理涉及伤口关闭,然后进行玻璃切除术,但最佳时间仍在争论中.

研究的目的:

为了比较早期和延迟的玻璃切除术在治疗OGI中的有效性.
评估玻璃切除术时间对视觉结果和解剖成功的影响.
确定最佳的手术时间,以最大限度地提高OGI后患者的预后.

主要方法:

根据PRISMA指南进行了一项元分析.
在Medline,Embase,Scopus,Cochrane和ClinicalTrials.gov数据库中进行了搜索 (截至2023年10月23日).
包括临床研究,比较OGI的早期 (7天内) 和延迟 (8-14天) 玻璃切除术,评估RCT和非RCT.

主要成果:

分析了11项涉及235名早期干预和211名延迟干预患者的研究.
早期玻璃切除术显示视网膜再附加率更高 (91%vs. 76%) 和视力敏度更好 (≥5/200概率2.4倍).
延迟手术与PVR发生率显著增加 (41%对9%) 和重复手术的需求增加有关.

结论:

早期的玻璃切除术在OGI管理中表现出优异的结果.
迅速的手术干预可以改善视力敏度和视网膜的重新连接.
延迟的玻璃切除术增加了PVR的风险,需要更复杂的手术管理.

关键词:

延迟的玻璃切除术早期的玻璃切除术开放的地球伤害伤害.创伤性增殖性玻璃红蛋白病变 (vitreoretinopathy) 是一种创伤性增殖性玻璃红蛋白病变.玻璃切除术时间表伤口修复伤口修复

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