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Cochrane Database of Systematic Reviews

Rangkaian silang kolagen kornea untuk keratitis jangkitan bakteria

Información

DOI:
https://doi.org/10.1002/14651858.CD013001.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 17 junio 2020see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Salud ocular y de la visión

Copyright:
  1. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • Shadi A Davis

    Correspondencia a: Ophthalmology and Ocuplastics Surgery, Cheyenne VA Hospital, Cheyenne, USA

    [email protected]

  • Renee Bovelle

    Department of Ophthalmology, Howard University, Washington, DC, USA

  • Genie Han

    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

  • John Kwagyan

    General Clinical Research Center, Howard University, Washington, USA

Contributions of authors

  • Conception and design of study (SAD, JK, RB)

  • Drafting the review or commenting on it critically for intellectual content (SAD, RB, JK, GH)

  • Final approval of the document to be published (SAD, JK, GH, RB)

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • Cochrane Eyes and Vision US Project, supported by grant 1 U01 EY020522, National Eye Institute, National Institutes of Health, USA

  • National Institute for Health Research (NIHR), UK

    • Richard Wormald, Co‐ordinating Editor for Cochrane Eyes and Vision (CEV) acknowledges financial support for his CEV research sessions from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

    • This review was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to the CEV UK editorial base.

    The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS, or the Department of Health.

Declarations of interest

RB: Dr Bovelle has within the past three years received speaker fees from Allergan, which are unrelated to this work.
SAD: none
GH: none
JK: none

Acknowledgements

Lori Rosman, Information Specialist for Cochrane Eyes and Vision, created and executed the electronic search strategies. We thank Tianjing Li and Henry Jampel for providing comments on the review. We also thank the following peer reviewers for their comments: Lindsay Sicks, OD, FAAO (Illinois College of Optometry) and Vishal Jhanji, MD (University of Pittsburgh School of Medicine).

We are grateful to Dr Robert A Copeland Jr, who passed in April 2016. Dr Copeland conceived, designed, and drafted the first version of the protocol. The authors have made edits to the protocol beyond his contribution, although the main components (population, interventions, comparisons, and outcomes) are consistent with his initial draft.

This review was managed by CEV@US and was signed off for publication by Tianjing Li and Richard Wormald.

Version history

Published

Title

Stage

Authors

Version

2020 Jun 17

Corneal collagen cross‐linking for bacterial infectious keratitis

Review

Shadi A Davis, Renee Bovelle, Genie Han, John Kwagyan

https://doi.org/10.1002/14651858.CD013001.pub2

2018 May 30

Corneal collagen cross‐linking for infectious keratitis

Protocol

Robert A Copeland Jr, Shadi A Davis, Young‐Joo Lee, John Kwagyan, Renee Bovelle

https://doi.org/10.1002/14651858.CD013001

Differences between protocol and review

We planned to search for additional eligible studies that had cited the trials included in this review using the Science Citation Index database. We also planned to search the reference lists of included trials and previous review articles to find any other pertinent studies. We chose not to conduct either of these searches because we believed the electronic search to be sufficient.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram.

Figuras y tablas -
Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Summary of findings 1. PACK‐CXL with standard therapy compared with standard therapy alone for bacterial keratitis

PACK‐CXL with standard therapy compared with standard therapy alone for bacterial keratitis

Patient or population: participants of any age with confirmed cases of bacterial keratitis

Settings: outpatient or inpatient

Intervention: PACK‐CXL with standard therapy

Comparison: standard therapy alone

Outcomes

Anticipated absolute effects (95% CI)

No. of participants
(studies)

Certainty of the evidence
(GRADE)

Comments

Proportion of participants with re‐epithelialization and complete healing with or without scar formation at 4 to 8 weeks

Assessed by slit‐lamp biomicroscopy

(RR 1.53, 95% CI 0.88 to 2.66)

15 (1 quasi‐RCT)

⊕⊝⊝⊝
very low1,2,3

Data were reported at 8 weeks.

Proportion of participants with BCVA of 20/100 or better at 4 to 8 weeks

Assessed using a logMAR chart

Not estimable

12 (1 quasi‐RCT)

⊕⊝⊝⊝
very low1,2,3

Data were reported at 8 weeks.

RR is not available because there were no participants with a BCVA of 20/100 or better at 8 weeks.

Mean change from baseline in BCVA at 4 to 8 weeks

Assessed using a logMAR chart

None

0

None

No data were reported.

Proportion of participants with a reduction in corneal infiltrate at 4 to 8 weeks

Assessed by outcome assessors

None

0

None

No data were reported.

Proportion of participants with reduction in intraocular inflammation at 4 to 8 weeks

Assessed by corneal keratic precipitates, anterior chamber cellular reaction, or other appropriate measure

None

0

None

No data were reported.

Proportion of participants with treatment failure at 4 to 8 weeks

Assessed by outcome assessors

(RR 0.50, 95% CI 0.05 to 4.98)

32 (1 RCT)

⊕⊕⊝⊝
low1,2

Data were reported at 14 days.

Proportion of participants with adverse events at 4 to 8 weeks

Assessed by outcome assessors

Not estimable

32 (1 RCT)

⊕⊕⊝⊝
low1,2

Data were reported at 14 days.

RR is not available because there were no participants with adverse events at 14 days.

BCVA: best‐corrected visual acuity; CI: confidence interval; logMAR: logarithm of the minimal angle of resolution; PACK‐CXL: photoactivated chromophore for collagen cross‐linking; RCT: randomized controlled trial; RR: risk ratio

GRADE Working Group grades of evidence
High certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low certainty: We are very uncertain about the estimate.

1Downgraded for imprecision (‐1) due to low sample size.
2Downgraded for risk of bias (‐1) as the study was at high risk of selection bias. The high risk of selection bias reflects the overall review, since masking of participants was not possible for the surgical arm.
3Downgraded for risk of bias (‐1) as the review is at high risk of performance bias.

Figuras y tablas -
Summary of findings 1. PACK‐CXL with standard therapy compared with standard therapy alone for bacterial keratitis
Ir a la tabla de la revisión