PURPOSE

To determine the relationship between time from symptom onset or presentation to repair and visual outcomes for macula-on and macula-off rhegmatogenous retinal detachment (RRD).

DESIGN

Meta-analysis.

METHODS

We searched MEDLINE, EMBASE, and Cochrane Library for randomized controlled trials and observational studies comparing best-corrected visual acuity (BCVA) based on time to RRD repair. Study identifiers, baseline characteristics, intervention characteristics, and visual outcomes were extracted. We conducted a random effects meta-analysis. Sensitivity analyses included leave-1-out and influence analyses. Primary outcomes included mean difference (MD) in final BCVA, MD between preoperative and final BCVA (∆BCVA), and relative risk of final BCVA <0.4 logMAR for macula-off RRD repair in 0-3 vs 4-7 days and macula-on RRD repair in 0-24 vs >24 hours. Secondary outcomes assessed other time points.

RESULTS

Twenty observational studies reported on 1929 patients. Macula-off RRD repair in 0-3 days from symptom onset was superior to 4-7 days for final BCVA (MD –0.06 [95% CI –0.09, –0.03], P < .001) but was not different for ∆BCVA (P > .05). Macula-on repair in 0-24 hours from presentation was superior to >24 hours for final BCVA (MD –0.02 [95% CI –0.03, –0.01], P < .05) but was not different for ∆BCVA (P > .05).

CONCLUSIONS

Macula-off RRD repair in 0-3 days from symptom onset may have better final BCVA compared to repair in 4-7 days. Macula-on RRD repair in 0-24 hours of presentation may have better final BCVA compared to repair in >24 hours. These results were supported by moderate- and low-quality evidence, respectively, and may have been influenced by differences in baseline BCVA.

中文翻译：

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手术时间对孔源性视网膜脱离修复视力结果的影响：荟萃分析

目的

确定从症状发作或表现到修复的时间与黄斑区和黄斑区孔源性视网膜脱离 (RRD) 的视觉结果之间的关系。

设计

荟萃分析。

方法

我们在 MEDLINE、EMBASE 和 Cochrane 图书馆中搜索了比较基于 RRD 修复时间的最佳矫正视力 (BCVA) 的随机对照试验和观察性研究。提取研究标识符、基线特征、干预特征和视觉结果。我们进行了随机效应荟萃分析。敏感性分析包括留一法和影响分析。主要结果包括最终 BCVA 的平均差 (MD)、术前和最终 BCVA 之间的 MD (ΔBCVA)，以及最终 BCVA <0.4 logMAR 的相对风险，用于 0-3 天和 4-7 天的黄斑脱落 RRD 修复和黄斑-在 0-24 小时内修复 RRD，而不是 >24 小时。次要结果评估其他时间点。

结果

20 项观察性研究报告了 1929 名患者。症状出现后 0-3 天内的黄斑 RRD 修复优于最终 BCVA 的 4-7 天（MD –0.06 [95% CI –0.09, –0.03]，P < .001），但 ΔBCVA 没有差异( P > .05)。对于最终 BCVA（MD –0.02 [95% CI –0.03, –0.01]， P < .05） ，就诊后 0-24 小时内的黄斑修复优于 >24 小时，但 ΔBCVA 没有差异（P > .05).

结论

与 4-7 天内的修复相比，症状出现后 0-3 天内的黄斑关闭 RRD 修复可能具有更好的最终 BCVA。与 >24 小时内的修复相比，出现 0-24 小时内的 RRD 黄斑修复可能具有更好的最终 BCVA。这些结果分别得到中等和低质量证据的支持，并且可能受到基线 BCVA 差异的影响。