两种人工晶状体植入术后发生后囊膜混浊情况的Meta分析
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Comparison of posterior capsule opacification after implantation of two different intraocular lenses: a Meta-analysis
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    摘要:

    目的:系统评价AcrySof直角方边人工晶状体和Sensar前圆后方人工晶状体对术眼后囊膜混浊的预防作用。

    方法:计算机检索PubMed(1980/2015-09)、CBM(1990/2015-09)、VIP(1989/2015-09)、CNKI(1990/2015-09)和wanfang Data(1990/2015-09),收集年龄相关性白内障超声乳化联合植入AcrySof三片式人工晶状体与植入Sensar三片式人工晶状体术后后囊膜混浊发生情况的随机对照试验,由两名评价者按照纳入与排除标准筛选研究、提取资料和质量评价后,采用RevMan 5.2软件进行Meta分析。

    结果:共纳入5项研究,总计1 036眼(AcrySof组553眼,Sensar组483眼),随访时限6mo~2a,Meta分析结果显示:(1)AcrySof组术后PCO发生率显著低于Sensar组(OR=0.67,95%CI:0.45~0.99,P=0.04);(2)两种人工晶状体植入后术眼后囊膜Nd:YAG激光切开术施行率比较,无统计学差异(OR=0.57,95%CI:0.32~1.02,P=0.06)。(3)2a以上长期随访亚组分析中,AcrySof组PCO发生率显著低于Sensar组(OR=0.60,95%CI:0.40~0.91,P=0.02),两组人工晶状体术后后囊膜激光切开术施行率比较,无统计学差异(OR=0.60,95%CI:0.33~1.09,P=0.09)。

    结论:AcrySof三片式人工晶状体相比于Sensar三片式人工晶状体显示出较强的预防后囊膜混浊作用。

    Abstract:

    AIM: To compare posterior capsule opacification(PCO)after phacoemulsification cataract surgery with implantation of two different hydrophobic acrylic intraocular lenses(IOLs).

    METHODS: Such databases as PubMed(1980-Sep 2015),CBM(1990-Sep 2015),VIP(1989-Sep 2015),CNKI(1990-Sep 2015)and WanFang Data(1990-Sep 2015)were searched to collect the randomized controlled trials(RCTs)about AcrySof 3-piece IOL vs Sensar 3-piece IOL for PCO or incidence of Nd:YAG laser capsulotomy.According to the inclusion and exclusion criteria,two reviewers independently screened the literatures,extracted data and assessed the quality of the included studies,then Meta-analysis was conducted using RevMan 5.2 software.

    RESULTS: A total of 5 RCTs involving 1 036 eyes(AcrySof group: 553 eyes, Sensar group: 483 eyes)were included, with a follow-up duration of 6mo~2a.The results of Meta-analysis showed that:(1)the incidence of PCO was significantly lower in AcrySof group than that in Sensar group(OR=0.67,95%CI:0.45~0.99,P=0.04);(2)the incidence of Nd:YAG laser capsulotomy after surgeries was similar between AcrySof group and Sensar group(OR=0.57,95%CI:0.32~1.02,P=0.06);(3)in an above 2a long-term follow-up subgroup analysis, AcrySof group indicated a significantly lower incidence of PCO(OR=0.60,95%CI:0.40~0.91,P=0.02), while the Nd:YAG laser capsulotomy incidence was similar between the two groups(OR=0.60,95%CI:0.33~1.09,P=0.09).

    CONCLUSION: AcrySof 3-piece IOL seems to have a stronger preventive effect on PCO than Sensar 3-piece IOL. For the quantity limitation of the included studies,this conclusion still needs to be further proved by more high-quality RCTs.

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朱怡,李岱,王思聪,等.两种人工晶状体植入术后发生后囊膜混浊情况的Meta分析.国际眼科杂志, 2016,16(4):642-646.

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  • 收稿日期:2015-12-22
  • 最后修改日期:2016-03-18
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  • 在线发布日期: 2016-03-28
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