白内障术前应用聚维酮碘冲洗结膜囊效果的Meta分析

Rinsing the conjunctival sac with povidone-iodine solution before cataract surgery: A meta-analysis

目的白内障术前常规冲洗结膜囊可预防眼内炎的发生。如何正确评估与选择合适的冲洗液是一个值得探讨的问题。文中分析了白内障术前应用聚维酮碘、等渗盐水及抗生素冲洗结膜囊的对照试验,讨论聚维酮碘冲洗结膜囊是否能有效降低结膜囊细菌阳性率,预防眼内炎症发生。方法检索Medline、Pubmed、Ovid、The Cochrane Library、EMBASE及中国生物医学文献数据库发表的有关聚维酮碘、等渗盐水及抗生素在白内障术前冲洗结膜囊效果的对照研究,并辅以手工检索、因特网搜索。共纳入4篇文章6项试验,分为2组对其疗效进行分析。结果聚维酮碘冲洗组与等渗盐水冲洗组相比能显著降低结膜囊细菌阳性率,差异有显著性统计学意义(P<0.0001),合并RR值为0.15,95%CI为[0.05,0.45],与抗生素冲洗组比较有显著差别,差异有显著性统计学意义(P<0.05),合并RR值为0.38,95%CI为[0.17,0.83]。结论白内障术前应用聚维酮碘冲洗结膜囊较等渗盐水及抗生素冲洗能显著降低术后结膜囊细菌培养阳性率,预防眼内炎症的发生。

Objective Rinsing the conjunctival sac before cataract surgery is a primary prevention of endophthalmitis.How to properly evaluate and select the appropriate solution is a question worth exploring.The purpose of this study is to compare the effects of ocular rinse with povidone-iodine solution,sodium chloride solution and antibiotic solution for cataract surgery by meta-analysis.Methods We conducted both computer-aided and hand searches of the Medline/PubMed,Ovid,Cochrane Library and EMBASE for the relevant control studies assessing the effects of ocular rinse with povidone-iodine solution,sodium chloride solution and antibiotic solution for cataract surgery.Six experiments in 4 studies were included and analyzed in two groups.Results Povidone-iodine solution was found to be significantly more effective than sodium chloride solution in reducing the positive rate of bacteria in the conjunctival sac(P<0.0001,pooled RR: 0.15 and 95% CI: 0.05,0.45),as well as than antibiotic solution(P<0.05,pooled RR: 0.38 and 95% CI: 0.17,0.83).Conclusion Rinsing the conjunctival sac with povidone-iodine solution before cataract surgery can effectively reducing postoperative infection.