后巩膜加固术治疗高度近视黄斑劈裂复位率及并发症率的Meta分析

The retinal reduction rate and complication rate of myopic foveoschisis treated by pos⁃terior scleral reinforcement:A Meta-analysis

目的通过Meta分析评估后巩膜加固术治疗高度近视黄斑劈裂的有效性及安全性。方法检索Cochrane Library、Pubmed、Web of Science、Embase、中国知网、万方、维普及中国生物医学文献数据库中,从建库至2020年4月发表的关于后巩膜加固术治疗高度近视黄斑劈裂的研究。采用Stata 12.0统计学软件分别对视网膜复位率及并发症发生率进行Meta分析。结果共纳入10篇文献(257只眼),其中有效性分析纳入10篇(257只眼),并发症分析纳入8篇(197只眼)。后巩膜加固术治疗高度近视黄斑劈裂的视网膜复位率MD=0.77,95%CI(0.62,0.89),P=0.000;并发症发生率为MD=0.38,95%CI(0.08,0.74),P=0.000,差异均有统计学意义。敏感性分析发现各研究对Meta分析结果均无明显影响,漏斗图及Egger线性回归分析显示,纳入的文献无明显发表偏倚。结论后巩膜加固术治疗高度近视黄斑劈裂得到良好的解剖复位,规避内眼手术感染风险,从长远来看仍然是目前手术治疗的一线方案,同时植入材料的改良能够一定程度上提高视网膜复位率,减少并发症发生。

OBJECTIVE To evaluate the efficacy and safety of posterior scleral reinforcement for the treatment of myopic foveoschisis(MF)through a Meta-analysis.METHODS The literatures in Cochrane Library,Pubmed,Web of science,Embase,CNKI and Wanfang database,VIP and Chinese Biomedical Literature Database from the establishment of the databases to April 2020 were searched.The main contents included the studies about posterior scleral reinforcement for MF.Meta-analysis of the retinal reduction rate and the incidence of complications was performed using Stata12.0 statistical software.RESULTS A total of ten studies(257 eyes)were included,among them,effectiveness analysis included ten studies(257 eyes)and complications analysis included eight studies(197 eyes).The retinal reduction rate of posterior scleral reinforcement in the treatment of MF:MD=0.77,95%CI(0.62,0.89),P=0.000,the overall incidence rate of complications:MD=0.38,95%CI(0.08,0.74),P=0.000,and the differences were statistically significant.No obvious interference from any paper was found by sensitivity analysis.No published bias was seen by funnel plots and Egger linear analysis.CONCLUSIONS Posterior scleral reinforcement for the treatment of MF can achieve favorable anatomical reduction and reduce the risk of infection in intraocular surgery,which is still the first-line surgical treatment in the long run.Meanwhile,the improvement of implant materials can improve the retinal reattachment rate to a certain extent and reduce the incidence of complications.