A meta-analysis of primary dacryocystorhinostomy with and without silicone intubation

作者:Feng Yi fan; Cai Jian qiu*; Zhang Jia yu; Han Xiao hui
来源:Canadian Journal of Ophthalmology, 2011, 46(6): 521-527.
DOI:10.1016/j.jcjo.2011.09.008

摘要

Objective: To examine possible differences in success rates of primary dacryocystorhinostomy (DCR) with and without silicone intubation, and to find out whether the use of silicone tubes is beneficial. Design: A literature search was conducted in the PubMed, EMBASE, and Cochrane Controlled Trials Register to identify potentially relevant controlled trials. Methods: Language was restricted to English. The surgical techniques were categorized into external OCR (EX-DCR), endonasal laser-assisted DCR (LA-DCR), and nonlaser endoscopic endonasal DCR techniques (EN-OCR). The main outcome measure was success rates after DCR-with and OCR-without silicone intubation. The statistical analysis was carried out using a Rev Man 5.0 software. Results: Of 188 retrieved trials from the electronic database, 9 trials (5 randomized controlled trials and 4 cohort studies) involving 514 cases met our inclusion criteria. There was no statistically significant heterogeneity between the studies. The pooled risk ratio was 0.99, with a 95% confidence interval (0.91-1.08). There was no significant difference in the success rates between the OCR with and without silicone intubation (p = 0.81). Sensitivity analysis and subgroups analyses suggested that the result was comparatively reliable. Conclusions: Based on this meta-analysis that included 5 randomized controlled trials and 4 cohort studies, no benefit was found for silicone tube intubation in primary OCR. Further well-organized, prospective, randomized studies involving larger patient numbers are required.

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