摘要
目的系统评价飞秒激光小切口角膜基质透镜切除术(SMILE)与有晶状体眼后房型人工晶状体(ICL)植入术矫正高度近视眼的效果。方法检索中国知网、万方数据库、维普数据库、PubMed、Medline及Cochrane Library,搜集行SMILE与ICL屈光术矫正高度近视眼的相关文献。采用Cochrane系统评价的方法,两位评价者独立进行文献检索、筛选、质量评价及数据提取。从选取的文件中提取患者的术后视力、干眼情况、手术的安全性与有效性以及术后视觉质量等结局指标。术后裸眼视力、术后最佳矫正视力、泪膜破裂时间、泪河高度、手术有效性和安全性、对比敏感度及高阶像差等结局指标均为计量资料,采用均数差(MD)及其95%置信区间(CI)作为统计分析量。各文献研究间的异质性采用Q和I2检验。如P<0.05或I2>50%则认为异质性较大。采用敏感性分析剔除发表偏倚差异较大的研究或存在高偏倚风险的研究,而后检测合并结果的稳定性,如剔除后异质性仍不显著降低,则采用随机效应模型进行分析;反之,采用固定效应模型。结果初步检索各数据库共获得文献59篇,去掉重复文献后剩余32篇,通过阅读文献标题、摘要及根据纳入与排除标准,剔除不符合要求的文献,最终本研究纳入7篇文献。7篇文献中行SMILE的有439只眼,植入ICL的有422只眼。各研究间患者术后最佳矫正视力和术后裸眼视力的组间异质性较大(I2=98%和89%)。经随机效应模型分析,SMILE组与ICL组对术后最佳矫正视力的比较,差异无统计学意义(MD=-0.02,95%CI:-0.03~0.08;P>0.05)。植入ICL组患者的术后裸眼视力较SMILE组更佳。经随机效应模型分析,两者比较的差异有统计学意义(MD=0.04,95%CI:0.00~0.07;P<0.05)。各研究间患者术后泪河高度和泪膜破裂时间的组间异质性均较小(I2=0)。经固定效应模型分析,两者比较的差异均无统计学意义(MD=-0.00,-0.13,95%CI:-0.03~0
Objective The aim of this study was to systematically evaluate the effects of femtosecond laser small incision lenticule extraction(SMILE)and posterior chamber phakic intraocular lens(ICL)implantation for the correction of high myopia.Methods A literature search was implemented in CNKI,Wanfang database,VIP database,PubMed,Embase and Cochrane Library.Two researchers independently performed literature search,screening,quality evaluation,and data extraction.Postoperative visual acuity,dry eye,safety,efficacy,and postoperative visual quality were analyzed.Postoperative uncorrected visual acuity,best corrected visual acuity,tear film break-up time,tear meniscus heigh,surgical efficiency and safety,contrast sensitivity and higher-order aberrations were all measured.Mean difference(MD)and its 95%confidence interval(CI)were used as statistical analysis variables.The heterogeneity among studies was tested by Q test and I^(2) test.If P<0.05 or I^(2)>50%,the heterogeneity was considered to be greater.Sensitivity analysis was used to eliminate studies with large publication bias differences or studies with high bias risk,and then the stability of the merger results was tested.If the heterogeneity was not significantly reduced after elimination,random effect model was performed;otherwise,fixed effect model was used.Results In all databases,59 literatures were retrieved.After excluding the repetitive 32 literatures,the literatures with in consistent contents or incomplete main outcome indicators and the literatures with data that cannot be extracted,there were 7 studies recruited for meta-analysis,including 439 eyes with SMILE and 422 eyes implanted with ICL.There was significant heterogeneity in postoperative best corrected visual acuity between them(I^(2)=98%)and postoperative uncorrected visual acuity(I^(2)=89%).After random effects model analysis,there was no statistically significant difference on postoperative best corrected visual acuity(MD=-0.02,95%CI:-0.03 to 0.08,P>0.05).The postoperative uncorrected visual acuity as
作者
何海龙
刘振宇
周春媛
张立平
王进达
万修华
He Hailong;Liu Zhenyu;Zhou Chunyuan;Zhang Liping;Wang Jinda;Wan Xiuhua(Master's degree 2018,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Master's degree 2019,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Master's degree 2018,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Master's degree 2018,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)
出处
《中华眼科医学杂志（电子版）》
2021年第1期22-28,共7页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
基金
国务院妇女儿童工作委员会课题(2014108)
北京市眼科研究所突破计划(201910)。
