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Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials
PURPOSE: To explore the effectiveness and safety of vitrectomy for congenital cataract surgery. METHODS: We searched PubMed, Science Direct, The Cochrane Library, China National Knowledge Infrastructure and the Wanfang Database. Two researchers extracted data and assessed paper quality independently...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587933/ https://www.ncbi.nlm.nih.gov/pubmed/30565873 http://dx.doi.org/10.1111/aos.13974 |
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author | Cao, Kai Wang, Jinda Zhang, Jingshang Yusufu, Mayinuer Jin, Shanshan Hou, Simeng Zhu, Guyu Wang, Bingsong Xiong, Ying Li, Jing Li, Xiaoxia Chai, Lijing He, Hailong Wan, Xiu H. |
author_facet | Cao, Kai Wang, Jinda Zhang, Jingshang Yusufu, Mayinuer Jin, Shanshan Hou, Simeng Zhu, Guyu Wang, Bingsong Xiong, Ying Li, Jing Li, Xiaoxia Chai, Lijing He, Hailong Wan, Xiu H. |
author_sort | Cao, Kai |
collection | PubMed |
description | PURPOSE: To explore the effectiveness and safety of vitrectomy for congenital cataract surgery. METHODS: We searched PubMed, Science Direct, The Cochrane Library, China National Knowledge Infrastructure and the Wanfang Database. Two researchers extracted data and assessed paper quality independently. Posterior capsule opacification (PCO) or visual axis opacification (VAO), reoperation rate, visual acuity, intraocular lenses (IOL) deposit, synechias, uveitis, secondary glaucoma, low‐contrast sensitivity and IOL decentration were compared. RESULTS: We included 11 randomized controlled trials (RCTs) with 634 congenital cataract eyes. Cases of posterior capsule opacification in vitrectomy group were significantly less than that of control group, with risk ratio (RR) of 0.15 [95% confidence interval (CI): 0.09, 0.26], and there was no heterogeneity (I (2 )= 0%, p = 0.94). Reoperation rate in vitrectomy group was lower than that of control group either (RR = 0.40, 95%CI: 0.17, 0.94), and there was no heterogeneity (I (2) = 0%, p = 0.85). Best‐corrected visual acuity (BCVA) measured in LogMAR unit of vitrectomy group was smaller, with a mean difference (MD) of −0.17 (95%CI: −0.28, −0.05), and I (2) was only 22%, indicating of a small heterogeneity. No statistical difference was found between two groups on IOL deposit (RR = 1.23, 95%CI: 0.70, 2.17), and the heterogeneity was small (I (2) = 16%, p = 0.31). No statistical difference was found between two groups on synechias (RR = 1.08, 95%CI: 0.60, 1.94), with a quite small heterogeneity (I (2) = 3%, p = 0.38). No statistical difference was found between two groups on uveitis (RR = 0.55, 95%CI: 0.15, 2.01), and there was no heterogeneity (I (2) = 0%, p = 0.94). There was no statistical difference on IOP either, with a MD of 0.25 (95%CI: −1.56, 2.07), and there was no heterogeneity (I (2) = 0%). Egger's test showed that there was no publication bias for all assessed outcomes. Low‐contrast sensitivity was better in the vitrectomy group. And no evidence indicated vitrectomy could lead to a higher risk on secondary glaucoma or IOL decentration. CONCLUSION: Vitrectomy helps lower the PCO risk and reoperation risk after congenital cataract surgery, and also, vitrectomy helps patients gain a better BCVA and achieve a better low‐contrast sensitivity, with no trade‐off on IOP control, IOL deposit, synechias, uveitis and secondary glaucoma. We recommend performing vitrectomy during congenital cataract surgery. |
format | Online Article Text |
id | pubmed-6587933 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-65879332019-07-02 Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials Cao, Kai Wang, Jinda Zhang, Jingshang Yusufu, Mayinuer Jin, Shanshan Hou, Simeng Zhu, Guyu Wang, Bingsong Xiong, Ying Li, Jing Li, Xiaoxia Chai, Lijing He, Hailong Wan, Xiu H. Acta Ophthalmol Review Article PURPOSE: To explore the effectiveness and safety of vitrectomy for congenital cataract surgery. METHODS: We searched PubMed, Science Direct, The Cochrane Library, China National Knowledge Infrastructure and the Wanfang Database. Two researchers extracted data and assessed paper quality independently. Posterior capsule opacification (PCO) or visual axis opacification (VAO), reoperation rate, visual acuity, intraocular lenses (IOL) deposit, synechias, uveitis, secondary glaucoma, low‐contrast sensitivity and IOL decentration were compared. RESULTS: We included 11 randomized controlled trials (RCTs) with 634 congenital cataract eyes. Cases of posterior capsule opacification in vitrectomy group were significantly less than that of control group, with risk ratio (RR) of 0.15 [95% confidence interval (CI): 0.09, 0.26], and there was no heterogeneity (I (2 )= 0%, p = 0.94). Reoperation rate in vitrectomy group was lower than that of control group either (RR = 0.40, 95%CI: 0.17, 0.94), and there was no heterogeneity (I (2) = 0%, p = 0.85). Best‐corrected visual acuity (BCVA) measured in LogMAR unit of vitrectomy group was smaller, with a mean difference (MD) of −0.17 (95%CI: −0.28, −0.05), and I (2) was only 22%, indicating of a small heterogeneity. No statistical difference was found between two groups on IOL deposit (RR = 1.23, 95%CI: 0.70, 2.17), and the heterogeneity was small (I (2) = 16%, p = 0.31). No statistical difference was found between two groups on synechias (RR = 1.08, 95%CI: 0.60, 1.94), with a quite small heterogeneity (I (2) = 3%, p = 0.38). No statistical difference was found between two groups on uveitis (RR = 0.55, 95%CI: 0.15, 2.01), and there was no heterogeneity (I (2) = 0%, p = 0.94). There was no statistical difference on IOP either, with a MD of 0.25 (95%CI: −1.56, 2.07), and there was no heterogeneity (I (2) = 0%). Egger's test showed that there was no publication bias for all assessed outcomes. Low‐contrast sensitivity was better in the vitrectomy group. And no evidence indicated vitrectomy could lead to a higher risk on secondary glaucoma or IOL decentration. CONCLUSION: Vitrectomy helps lower the PCO risk and reoperation risk after congenital cataract surgery, and also, vitrectomy helps patients gain a better BCVA and achieve a better low‐contrast sensitivity, with no trade‐off on IOP control, IOL deposit, synechias, uveitis and secondary glaucoma. We recommend performing vitrectomy during congenital cataract surgery. John Wiley and Sons Inc. 2018-11-22 2019-05 /pmc/articles/PMC6587933/ /pubmed/30565873 http://dx.doi.org/10.1111/aos.13974 Text en © 2018 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Review Article Cao, Kai Wang, Jinda Zhang, Jingshang Yusufu, Mayinuer Jin, Shanshan Hou, Simeng Zhu, Guyu Wang, Bingsong Xiong, Ying Li, Jing Li, Xiaoxia Chai, Lijing He, Hailong Wan, Xiu H. Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title | Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title_full | Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title_fullStr | Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title_full_unstemmed | Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title_short | Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
title_sort | efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587933/ https://www.ncbi.nlm.nih.gov/pubmed/30565873 http://dx.doi.org/10.1111/aos.13974 |
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