目的:比较高或低浓度的透明质酸滴眼液(HY)用于干眼综合征(DES)。
方法:在PubMed,Embase,WebofScience,科克伦,SinoMed,CNKI,万方数据库,CQVIP,和中国期刊数据库在始创至2023年7月之间。来自评估SchirmerI检验(SIT)的RCT的具有95%置信区间(CI)的汇总标准化平均差(SMD)或加权平均差(WMD),角膜荧光素染色评分(CFS),撕裂破裂时间(TBUT),DES评分(DESS),计算眼表疾病指数(OSDI)。敏感性分析,对所有指标进行Egger检验和Meta回归分析。
结果:我们对10个符合纳入标准的RCT进行了Meta分析,涉及1796例。根据随机效应模型(SMD,-3.37;95CI,-5.25至-1.48;P=0.0005)。其余结果无统计学意义,包括SIT等指标,TBUT,DESS和OSDI。
结论:对于角膜染色阳性的干眼,建议使用高浓度的HY,而在其他情况下,在干眼的治疗中,高浓度的HY与低浓度的HY相比没有提供更明显的优势。
OBJECTIVE: To compare high or low concentration of hyaluronic acid eye drops (HY) for dry eye syndromes (DES).
METHODS: Randomized controlled trials (RCTs) comparing various concentrations of HY were searched in PubMed, Embase, Web of Science, Cochrane, SinoMed, CNKI, Wanfang Database, CQVIP, and Chinese journals databases between inception and July 2023. Pooled standardized mean differences (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CI) from RCTs evaluating Schirmer\'s I test (SIT), corneal fluorescein staining score (CFS), tear breakup time (TBUT), DES score (DESS), and Ocular Surface Disease Index (OSDI) were calculated. Sensitivity analysis, Egger\'s test and Meta-regression analysis were performed for all indicators.
RESULTS: We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria, involving 1796 cases. High-concentrations group significantly improved the outcome of CFS according to random effects modelling (SMD, -3.37; 95%CI, -5.25 to -1.48; P=0.0005). The rest of the results were not statistically significant, including indicators such as SIT, TBUT, DESS and OSDI.
CONCLUSIONS: For dry eyes with positive corneal staining, a high concentration of HY is recommended, whereas in other cases, a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.