[关键词]
[摘要]
目的:评价双眼外直肌后徙与单眼一退一截手术对基本型间歇性外斜视手术疗效。
方法:电子检索1970-01/2018-01的PubMed数据库、EMBASE、Cochrane library、Web of Science、Clinical Trial,中国生物医学文献数据库、万方医学网。纳入比较双眼外直肌后徙与单眼一退一截手术对基本型间歇性外斜视手术疗效的随机对照研究。由两名评价员独立收集数据并对所得数据及试验质量进行评价,采用STATA14版进行统计分析。
结果:共有5项试验、529例患者符合纳入标准。Meta分析结果提示:与单眼一退一截手术相比,双眼外直肌后徙术术后远期正位率(RR:0.85; 95% CI:0.72~0.99,P=0.043)、术后欠矫(RR:3.975; 95% CI:2.097~7.537, P<0.01)方面差异有统计学意义,远期术后正位率Meta分析的P值随着纳入文献增多逐渐接近0.05。而在术后过矫(RR:0.336; 95% CI:0.049~2.294, P=0.266)差异无统计学意义。
结论:双眼外直肌后徙术相比于单眼一退一截手术对基本型间歇性外斜视手术成功率略低,术后欠矫较明显。
[Key word]
[Abstract]
AIM:To compare the curative effect between monocular lateral rectus recession(BLR)and Binocular recession resection(R & R)for basic intermittent exotropia.
METHODS:A literature review using the MEDLINE, EMBASE, The Cochrane Library, Web of Science, Clinical Trial, CBM, Wanfang Databases and paper collections of conferences was performed. Randomized controlled trials comparing the effects of BLR and R & R for basic intermittent exotropia with a duration of follow-up at least half a year were eligible for inclusion. The methodologic quality of included studies was evaluated independently by 2 authors. Statistical analysis was performed by using the STATA 14 software(StataCorp Texas USA).
RESULTS:Five prospective random controlled clinical trials involving 529 patients were included. Compared with R & R procedure,the BLR procedure group showed lower successful rate(RR:0.85; 95% CI:0.72-0.99; P=0.043)and postoperative undercorrection(RR:3.975; 95% CI:2.097-7.537; P<0.01). The P value of long-term postoperative corrected rate in Meta analysis was decreased near to 0.05 when the included references increased. There was no significant difference in overcorrection rate between the BLR and R & R procedures(RR:0.336; 95% CI:0.049-2.294; P=0.266).
CONCLUSION:Current evidences suggested that BLR procedure is related to lower successful and higher undercorrection rates for basic intermittent exotropia compared to conventional R & R procedure.
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[基金项目]
国家自然科学基金青年项目(No.81300791); 天津市应用基础与前沿技术研究计划青年项目(No.14JCQNJC10500); 天津市自然科学基金面上项目(No.18JCYBJC26500)