Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it is a key ocular fundus disease that needs to be paid attention to in the next five years according to the "14th Five-Year" Plan for Eye Health. Promoting the systematic management of DR and constructing the chronic disease management system are the key to the next step of national eye health work. It is necessary to further improve the management mode of the whole course of DR patients with chronic eye disease through the joint action of medical security system at all levels, including strengthening supporting policies of primary medical institutions, optimizing medical service mode and process, strengthening scientific education to improve patients' and doctors' disease cognition, and updating authoritative Chinese DR guidelines to standardize diagnosis and treatment. It is hoped that the low vision and blindness caused by DR in China can be greatly reduced after the implementation of the "14th Five-Year" Plan for Eye Health.
【摘要】 目的 对比玻璃体手术和巩膜环扎术对治疗非复杂性孔源性视网膜剥离（rhegmotogenous retinal detachment，RRD）的疗效。 方法 检索Pubmed、Embase、Cochrane对照试验中心注册数据库，对相关的随机对照临床试验（randomized controlled trialc，RCT）按Cochrane协作网推荐的方法进行Meta分析。 结果 有晶状体组包括3篇RCT共523例，人工晶状体/无状晶体组包括4篇RCT共690例。有晶状体组玻璃体手术（pars plana vitrectomy，PPV）术后白内障的发生率更高[OR=4.18，95%CI（2.75，6.35），Plt;0.000 01]。人工晶状体/无晶状体组PPV术后最终解剖复位率更高[OR=1.97，95%CI（1.04，3.73），P=0.04]。 结论 巩膜环扎术通过降低术后白内障的发生率在治疗非复杂性有晶状体眼RRD中占有优势；PPV可提高最终解剖复位率，更适合人工晶状体/无晶状体眼RRD。【Abstract】 Objective To compare the efficacy of pars plana vitrectomy (PPV) and scleral buckling (SB) in treating uncomplicated rhegmatogenous retinal detachment (RRD). Methods Randomized controlled trials (RCTs) were searched from Pubmed, Embase and the Cochrane Central Register. Meta-analysis was conducted using the methods recommended by the Cochrane Collaboration. Results Three RCTs with 523 phakic eyes and four RCTs with 690 pseudophakic/aphakic eyes were included. In the phakic group, the rate of postopertative cataract was higher with PPV [OR=4.18, 95% CI (2.75,6.35), Plt;0.000 01]. In the pseudophakic/aphakic group, final anatomic success outcome was in favor of PPV [OR=1.97, 95% CI (1.04,3.73), P=0.04]. Conclusions SB results better in terms of postoperative cataract in phakic RRDs. PPV is more likely to achieve a favorable final reattachment in pseudophakic/aphakic RRDs.