Meta-analysis of effect of endoscopic transnasal optic canal decompression on traumatic optic neuropathy and its safety

Objective To evaluate the clinical effect of endoscopic transnasal optic canal decompression(ETOCD) on traumatic optic neuropathy(TON) and its safety.Methods The databases of Pubmed(1966 to April 2012),Embase(1974 to April 2012),the Cochrane clinical trials database(2012),Chinese Biomedical Literature Database(CBM,1978 to 2012 April),Weipu database(VIP,1989 to 2012 April),China Journal Full-text Database(CNKI,1994 to 2012 April),Wanfang Database(1997 to April 2012) were searched for randomized controlled trials(RCTs) or controlled clinical trials(CT) comparing ETCOD treatment with steroids or traditional optic canal decompression(TOCD) treatment of TON.Cochrane Systematic Review Handbook(version,5.0.0) was used to assess the quality of studies and the RevMan 5.1 software was used to analyze the data.Results We screened 12 eligible studies including 1 176 patients with TON.The visual power level was significantly improved in the patients treated with ETOCD compared with those treated with steroids [odds ratio(OR): 1.83;95% confidence interval(CI): 1.09～3.06;P0.05].There were no significant difference in the improvement of postoperative visual power between the patients treated with ETOCD and ones treated with TOCD(OR: 0.71;95% CI: 0.47～1.06;P0.05).ConclusionsThe curative effect of ETOCD on TON is better than that of steroids.Although ETOCD is similar to TOCD in the curative effects on TON,ETOCD is of the advantages including less operative side-injury,patient's rapid recovery,shorter operation time and less complication compared to TOCD.