Zhao Yang, Yang Ke, Li Jiaxin, Huang Yang, Zhu Siquan
Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing Medical School, Pingdingshan University, Pingdingshan Department of ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing, China.
Medicine (Baltimore). 2017 Nov;96(44):e8301. doi: 10.1097/MD.0000000000008301.
Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO.
Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens. Eligible studies included randomized controlled trials (RCTs), retrospective, and cohort studies.
Eleven studies were included in the study with a total of 889 eyes/patients. The overall analysis revealed that hydrophobic intraocular lenses were associated with lower Nd:YAG laser capsulotomy rates than hydrophilic lenses [odds ratio (OR) = 0.38, 95% confidence interval (95% CI) = 0.16-0.91, P = .029]. Hydrophobic intraocular lenses were also associated with lower subjective PCO score (diff. in means: -1.32, 95% CI = -2.39 to -0.25, P = .015) and estimated PCO score (diff. in means: -2.23; 95% CI, -3.80 to -0.68, P = .005) as compared with hydrophilic lenses. Objective PCO score was similar between lens types. (diff. in means: -0.075; 95% CI, -0.18 to 0.035; P = .182). Pooled analysis found that visual acuity was similar between hydrophobic and hydrophilic intraocular lenses (diff. in means: -0.016; 95% CI, -0.041 to 0.009, P = .208).
In general, PCO scores and the rate of Nd:YAG laser capsulotomy were influenced by intraocular lens biomaterial. Lens made of hydrophobic biomaterial were overall superior in lowering the PCO score and the Nd:YAG laser capsulotomy rate, but not visual acuity.
后囊膜混浊(PCO)是白内障手术常见的远期并发症。人工晶状体的设计和材料被认为会影响PCO的发生发展。本研究评估了疏水性和亲水性人工晶状体在预防PCO方面的关联。
检索Medline、Cochrane、EMBASE和谷歌学术数据库直至2016年8月3日,使用以下检索词:白内障、后囊膜混浊和人工晶状体。符合条件的研究包括随机对照试验(RCT)、回顾性研究和队列研究。
本研究纳入了11项研究,共889只眼/患者。总体分析显示,疏水性人工晶状体与亲水性人工晶状体相比,钕:钇铝石榴石激光晶状体切开术的发生率更低[优势比(OR)=0.38,95%置信区间(95%CI)=0.16 - 0.91,P = 0.029]。与亲水性人工晶状体相比,疏水性人工晶状体还与更低的主观PCO评分(均值差异:-1.32,95%CI = -2.39至-0.25,P = 0.015)和估计PCO评分(均值差异:-2.23;95%CI,-3.80至-0.68,P = 0.005)相关。不同类型晶状体的客观PCO评分相似。(均值差异:-0.075;95%CI,-0.18至0.035;P = 0.182)。汇总分析发现,疏水性和亲水性人工晶状体之间的视力相似(均值差异:-0.016;95%CI,-0.041至0.009,P = 0.208)。
总体而言,PCO评分和钕:钇铝石榴石激光晶状体切开术的发生率受人工晶状体生物材料的影响。由疏水性生物材料制成的晶状体在降低PCO评分和钕:钇铝石榴石激光晶状体切开术发生率方面总体更优,但对视力无影响。