非甾体类抗炎药预防白内障术后黄斑囊样水肿的Meta分析

Non steroidal anti-inflammatory drugs for preventing cystoid macular edema after cataract surgeries:a Meta-analysis

摘要:

目的：系统评价非甾体类抗炎药物对白内障术后黄斑囊样水肿的预防作用。

方法：计算机检索PubMed、EMbase、Cochrane Library、Medline、CNKI、万方、维普及中国生物医学文献数据库收录的，因特网搜索的截止到2015-03有关非甾体类抗炎药物对白内障术后黄斑囊样水肿预防作用研究的随机对照试验(RCT)， 同时手工检索相关书籍、期刊和会议论文及其参考文献。按照纳入和排除标准限定研究对象，针对白内障术后黄斑囊样水肿发生率，使用Cochrane协作网提供的RevMan5.2软件进行Meta分析。

结果：7项研究纳入分析(共1422例，其中治疗组712例，对照组710例)，白内障手术前后使用非甾体类抗炎药进行治疗，可显著降低术后黄斑水肿发生率(OR=0.31，95%CI：0.18～0.52，P<0.01)。

结论：白内障手术前后使用非甾体类抗炎药进行治疗，可显著降低术后黄斑水肿发生率，预防白内障术后黄斑水肿的发生，由于纳入研究的样本量偏小，且方法学质量中等，致使本系统评价结果论证强度不高，因此还需要开展更多的高质量的临床随机对照研究，以便更客观、准确、全面地评价。

Abstract:

AIM:To systematic evaluate the preventive effect of non-steroidal anti-inflammatory drugs(NSAIDs)on the cystoid macular edema(CME)after the cataract surgery.

METHODS:Searching literature which were published by March 2015 and which were the random control test(RCT)on the preventive effect of NSAIDs on CME after the cataract surgery in PubMed, EMbase, Cochrane Library, MEDLINE, CNKI, Wanfang Data, Chongqing Weipu and Chinese biomedical literature database and through Internet with computer. Meanwhile, relevant articles, journals, conference papers and their reference were manually retrieved. According to inclusion and exclusion criteria,the study objects were limited.Revman5.0 software provided by the Cochrane Collaboration was used to analysis the incidence of CME after cataract surgeries.

RESULTS:A total of 7 RCT were included in the study(1422 cases, 712 cases in the trial group, 710 cases in the control group). Using NSAIDs before and after cataract surgeries could significantly reduce the post-operative incidence of CME(OR=0.31, 95%CI:0.18～0.52, P<0.001).

CONCLUSION:Using NSAIDs before and after cataract surgeries can significantly reduce the incidence of postoperative CME. Due to the small sample size and the medium methodological quality, the conclusion is not powerful enough. More high-quality RCTs with larger sample size are needed to make the evaluation more objective, accurate and comprehensive.