Kobashi Hidenaga, Kamiya Kazutaka, Hoshi Keika, Igarashi Akihito, Shimizu Kimiya
Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
Department of Preventive Medicine, University of Kitasato School of Medicine, Kanagawa, Japan.
PLoS One. 2014 Jul 29;9(7):e103605. doi: 10.1371/journal.pone.0103605. eCollection 2014.
To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided photorefractive keratectomy (PRK).
The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trials. Trials meeting the selection criteria were quality appraised, and data was extracted by 2 independent authors. Measures of association were pooled quantitatively using meta-analytical methods. Comparisons between wavefront-guided and non-wavefront-guided ablations were made as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean differences and 95% CIs were used to compare induced HOAs.
The study covered five trials involving 298 eyes. After wavefront-guided PRK, the pooled OR of achieving an uncorrected distance visual acuity of 20/20 (efficacy) was 1.18 (95% CI, 0.53-2.60; p = 0.69), the pooled OR of achieving a result within ±0.50 diopter of the intended target (predictability) was 0.86 (95% CI, 0.40-1.84; p = 0.70). No study reported a loss of 2 or more lines of Snellen acuity (safety) with either modality. In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower. There were no significant differences between the two groups in the postoperative total HOAs (mean difference -0.04; 95% CI, -0.23 to 0.14; p = 0.63), spherical (mean difference 0.00; 95% CI, -0.08 to 0.09; p = 0.93), and coma (mean difference -0.06; 95% CI, -0.14 to 0.03; p = 0.20) aberrations.
According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.
比较波前引导的准分子激光角膜切削术（PRK）与非波前引导的PRK在疗效、可预测性、安全性及诱导产生的高阶像差（HOAs）方面的差异。
检索Cochrane对照试验中央注册库、PubMed及EMBASE以查找随机对照试验。对符合纳入标准的试验进行质量评估，由两名独立作者提取数据。采用荟萃分析方法对关联度量进行定量合并。波前引导消融与非波前引导消融之间的比较以合并比值比（ORs）或加权平均差表示。计算疗效、安全性及可预测性的合并ORs及95%置信区间（CIs）。采用加权平均差及95% CIs比较诱导产生的HOAs。
该研究涵盖五项试验，涉及298只眼。波前引导的PRK术后，实现未矫正远视力20/20（疗效）的合并OR为1.18（95% CI，0.53 - 2.60；p = 0.69），达到预期目标±0.50屈光度范围内结果（可预测性）的合并OR为0.86（95% CI，0.40 - 1.84；p = 0.70）。没有研究报告两种方式中有任何一种导致Snellen视力下降2行或更多行（安全性）。在波前引导的PRK术后的眼中，术后三叶草像差（平均差 -0.02；95% CI，-0.03至 -0.00；p = 0.03）显著更低。两组术后总HOAs（平均差 -0.04；95% CI，-0.23至0.14；p = 0.63）、球差（平均差0.00；95% CI，-0.08至0.09；p = 0.93）及彗差（平均差 -0.06；95% CI，-0.14至0.03；p = 0.20）像差无显著差异。
根据荟萃分析，波前引导的PRK在疗效、可预测性或安全性方面相较于非波前引导的PRK并无优势，但它可能诱导产生的三叶草像差较少。
Zotero 插件
