In the absence of large trials, it is important for us to discuss whether a well-conducted meta-analysis of smaller randomized controlled trial (RCT) can replace large trials or not. We have evaluated the quality of original literature and methodological quality. The difference between meta-analysis of smaller RCT and the largest randomized trials have also discussed.
Objective To observe the effects of vitrectomy for persistent fetal vasculature (PFV).Methods The clinical data of 11 patients (14 eyes) with PFV, including posterior PFV (one eye) and combined PFV (13 eyes), were retrospectively analyzed. Vitrectomy was performed for all patients, lensectomy was performed for seven eyes, retinotomy was performed for five eyes, retinotomy and scleral buckling was performed for one eye. Intraoperative and postoperative complications were observed. The followup period ranged from eight to 74 months, with the mean of 44 months. The visual acuity （VA） and intraocular pressure before and after surgery were comparatively analyzed.Results There were no intraoperative complications in all the patients. The surgery was performed successfully in 12 eyes （86.0%） and failed in two eyes （14.0%）. The postoperative VA of five eyes (35.7%) increased, four eyes （28.6%） didnprime;t change and five eyes （35.7%） decreased. The postoperative intraocular pressure of two eyes （14.3%） increased,11 eyes （78.6%） didnprime;t change and one eye （7.1%） decreased. There was one eye with persistent hypotension and one eye with recurrent retinal detachment after surgery.Conclusion Vitrectomy can prevent complications and improve visual acuity in some PFV patients.
In the process of evidence-based practice, the evaluation of evidence applicability relied on the subjective judgment of clinicians, while the systematic method of which was still in lack. The complex clinical information of traditional Chinese medicine (TCM) enhanced the uncertainty and risk of applying evidence. Based on the analysis of the process of evidence-based practice, this paper introduced the method of TCM evidence applicability evaluation and used the raw data of clinical trials to develop a clinical prediction model to enable the assessment of the evidence applicability on individual patients. The establishment of individual evidence applicability evaluation method could promote the rational application of TCM evidence in the long term.