目的:运用Meta方法评价玻璃体切除(PPV)联合内界膜剥除术(ILMP)治疗糖尿病性黄斑水肿(DME)临床疗效。方法:检索自从建库以来至2022年12月的维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang Data)、中国知网(...目的:运用Meta方法评价玻璃体切除(PPV)联合内界膜剥除术(ILMP)治疗糖尿病性黄斑水肿(DME)临床疗效。方法:检索自从建库以来至2022年12月的维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang Data)、中国知网(CNKI)、PubMed、Embase、Cochrane、等相关文献,搜集PPV联合ILMP治疗DME的临床随机对照试验(RCT)的相关文献研究,使用RevMan5.4、Stata17.0等软件对纳入文献的相关数据进行统计学分析。结果:本研究纳入7项文献,合计431只眼。Meta分析结果表明,1) 最佳矫正视力(BCVA):术后1个月(MD = −0.26, 95%CI [−0.37, −0.14], z = 4.30, P MD = −0.13, 95%CI [−0.21, −0.04], z = 2.94, P = 0.003 MD = −0.11, 95%CI [−0.16, −0.06], z = 4.22, P MD = −0.08, 95%CI [−0.13, −0.03], z = 3.36, P = 0.0008 MD = −47.11, 95%CI [−50.69, −43.53], z = 25.77, P MD = −53.62, 95%CI [−100.78, −6.45], z = 2.23, P = 0.03 Objective: To evaluate the clinical efficacy of vitrectomy combined with inner limiting membrane peeling (ILMP) in the treatment of diabetic macular edema (DME). Methods: Relevant articles were searched from VIP, CBM, Wanfang Data, CNKI, PubMed, Embase, Cochrane Library and other databases from the establishment of the database to December 2022. The relevant literatures of randomized controlled trials (RCTS) of PPV combined with ILMP in the treatment of DME were collected. Stata17.0 and RevMan5.4 software were used for Meta-analysis of the inclusion study. Results: A total of 7 RCTS were included in the experiment with a total of 431 eyes. The results of Meta-analysis showed that 1) Best corrected visual acuity (BCVA): The mean changes in BCVA at 1 month (MD = −0.26, 95%CI [−0.37, −0.14], z = 4.30, P MD = −0.13, 95%CI [−0.21, −0.04], z = 2.94, P = 0.003 MD = −0.11, 95%CI [−0.16, −0.06], z = 4.22, P MD = −0.08, 95%CI [−0.13, −0.03], z = 3.36, P = 0.0008 MD = −53.62, 95%CI [−100.78, −6.45], z = 2.23, P = 0.03 MD = −47.11, 95%CI [−50.69, −43.53], z = 25.77, P < 0.00001) after surgery can prove that compared with vitrectomy alone, vitrectomy combined with internal limiting membrane peeling could significantly lower central retinal thickness. Conclusions: PPV combined with ILMP in the treatment of DME is better than PPV alone.展开更多
目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和...目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和移植组(n=20,20只眼)。翻转组采用PPV联合内界膜翻转覆盖术治疗,移植组采用PPV联合游离内界膜移植术治疗。观察2组术后2周裂孔闭合率,术前和术后2周和术后1、3、6个月最小视角对数视力表最佳矫正视力(log MAR BCVA)、眼压的水平及术后手术相关并发症、随访6个月的裂孔复发情况。频域光学相干断层成像(SD-OCT)的图像观察MH直径(测量MH最小直径及基底部最大直径)及MH是否闭合。结果术后2周翻转组裂孔闭合率为100.0%,移植组为95.0%。2组术后2周裂孔闭合率比较差异无统计学意义(P>0.05)。log MAR BCVA:翻转组术前为1.01±0.24,术后2周为0.82±0.32和术后1个月为0.72±0.45、术后3个月为0.52±0.25、术后6个月为0.53±0.42;移植组术前为1.09±0.32,术后2周为0.95±0.45和术后1个月为0.93±0.14、术后3个月为0.81±0.24、术后6个月为0.70±0.23。2组术后log MAR BCVA均较术前明显提高,差异有统计学意义(P<0.05);翻转组术后2周和术后1、3、6个月log MAR BCVA均较移植组明显提高,差异有统计学意义(P<0.05)。2组术后2周和术后1、3、6个月眼压与术前比较差异无统计学意义(P>0.05);2组术后均未出现手术相关并发症;2组均随访6个月,均无裂孔复发。结论PPV联合内界膜翻转覆盖术治疗大直径MH效果与PPV联合游离内界膜移植术治疗相当,但翻转组术后log MAR BCVA优于移植组。展开更多
文摘目的:运用Meta方法评价玻璃体切除(PPV)联合内界膜剥除术(ILMP)治疗糖尿病性黄斑水肿(DME)临床疗效。方法:检索自从建库以来至2022年12月的维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang Data)、中国知网(CNKI)、PubMed、Embase、Cochrane、等相关文献,搜集PPV联合ILMP治疗DME的临床随机对照试验(RCT)的相关文献研究,使用RevMan5.4、Stata17.0等软件对纳入文献的相关数据进行统计学分析。结果:本研究纳入7项文献,合计431只眼。Meta分析结果表明,1) 最佳矫正视力(BCVA):术后1个月(MD = −0.26, 95%CI [−0.37, −0.14], z = 4.30, P MD = −0.13, 95%CI [−0.21, −0.04], z = 2.94, P = 0.003 MD = −0.11, 95%CI [−0.16, −0.06], z = 4.22, P MD = −0.08, 95%CI [−0.13, −0.03], z = 3.36, P = 0.0008 MD = −47.11, 95%CI [−50.69, −43.53], z = 25.77, P MD = −53.62, 95%CI [−100.78, −6.45], z = 2.23, P = 0.03 Objective: To evaluate the clinical efficacy of vitrectomy combined with inner limiting membrane peeling (ILMP) in the treatment of diabetic macular edema (DME). Methods: Relevant articles were searched from VIP, CBM, Wanfang Data, CNKI, PubMed, Embase, Cochrane Library and other databases from the establishment of the database to December 2022. The relevant literatures of randomized controlled trials (RCTS) of PPV combined with ILMP in the treatment of DME were collected. Stata17.0 and RevMan5.4 software were used for Meta-analysis of the inclusion study. Results: A total of 7 RCTS were included in the experiment with a total of 431 eyes. The results of Meta-analysis showed that 1) Best corrected visual acuity (BCVA): The mean changes in BCVA at 1 month (MD = −0.26, 95%CI [−0.37, −0.14], z = 4.30, P MD = −0.13, 95%CI [−0.21, −0.04], z = 2.94, P = 0.003 MD = −0.11, 95%CI [−0.16, −0.06], z = 4.22, P MD = −0.08, 95%CI [−0.13, −0.03], z = 3.36, P = 0.0008 MD = −53.62, 95%CI [−100.78, −6.45], z = 2.23, P = 0.03 MD = −47.11, 95%CI [−50.69, −43.53], z = 25.77, P < 0.00001) after surgery can prove that compared with vitrectomy alone, vitrectomy combined with internal limiting membrane peeling could significantly lower central retinal thickness. Conclusions: PPV combined with ILMP in the treatment of DME is better than PPV alone.
文摘目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和移植组(n=20,20只眼)。翻转组采用PPV联合内界膜翻转覆盖术治疗,移植组采用PPV联合游离内界膜移植术治疗。观察2组术后2周裂孔闭合率,术前和术后2周和术后1、3、6个月最小视角对数视力表最佳矫正视力(log MAR BCVA)、眼压的水平及术后手术相关并发症、随访6个月的裂孔复发情况。频域光学相干断层成像(SD-OCT)的图像观察MH直径(测量MH最小直径及基底部最大直径)及MH是否闭合。结果术后2周翻转组裂孔闭合率为100.0%,移植组为95.0%。2组术后2周裂孔闭合率比较差异无统计学意义(P>0.05)。log MAR BCVA:翻转组术前为1.01±0.24,术后2周为0.82±0.32和术后1个月为0.72±0.45、术后3个月为0.52±0.25、术后6个月为0.53±0.42;移植组术前为1.09±0.32,术后2周为0.95±0.45和术后1个月为0.93±0.14、术后3个月为0.81±0.24、术后6个月为0.70±0.23。2组术后log MAR BCVA均较术前明显提高,差异有统计学意义(P<0.05);翻转组术后2周和术后1、3、6个月log MAR BCVA均较移植组明显提高,差异有统计学意义(P<0.05)。2组术后2周和术后1、3、6个月眼压与术前比较差异无统计学意义(P>0.05);2组术后均未出现手术相关并发症;2组均随访6个月,均无裂孔复发。结论PPV联合内界膜翻转覆盖术治疗大直径MH效果与PPV联合游离内界膜移植术治疗相当,但翻转组术后log MAR BCVA优于移植组。
