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同轴微小切口与标准切口超声乳化白内障吸除术治疗年龄相关性白内障疗效的Meta分析

Comparison of efficacy between coaxial microincision and standard-incision phacoemulsification in patients with age-related cataracts: a meta-analysis.

作者信息

Wang Lijun, Xiao Xiao, Zhao Lin, Zhang Yi, Wang Jianming, Zhou Aiyi, Wang Jianchao, Wu Qian

机构信息

Department of Ophthalmology, the Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China.

Department of Ophthalmology, the Central Hospital of Shaanxi Xi'an, 161 Xiwu Road, Xi'an, 710004, China.

出版信息

BMC Ophthalmol. 2017 Dec 29;17(1):267. doi: 10.1186/s12886-017-0661-6.

DOI:10.1186/s12886-017-0661-6
PMID:29284444
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5747124/
Abstract

BACKGROUND

Incision size plays a critical role in the efficacy of cataract surgery, but the available evidence on ideal incision size is inconsistent. In this study, we conducted a meta-analysis to evaluate the efficacy of coaxial microincisional phacoemulsification surgery (MICS) compared with that of standard-incision phacoemulsification surgery (SICS) in patients with age-related cataracts.

METHODS

The Cochrane Library (Wiley Online Library), PubMed, Medline, National Knowledge Infrastructure (CNKI), and VIP databases were searched to identify reports of clinical randomized controlled trials (RCTs) comparing MICS to SICS for the treatment of age-related cataracts. The outcomes of interest included surgically induced astigmatism (SIA), effective phacoemulsification time (EPT), central corneal thickness (CCT), endothelial cell count (ECC), endothelial cell count loss (ECC Loss %), and average ultrasonic energy (AVE).

RESULTS

Eleven RCT studies were included in this meta-analysis. No statistically significant differences were observed in EPT (Z = 1.29, P > 0.05), CCT (1 day: Z = 1.37, P > 0.05; 7 days: Z = 0.75, P > 0.05; 30 days: Z = 0.38, P > 0.05; 90 days: Z = 0.29, P > 0.05), ECC (7 days: Z = 1.13, P > 0.05; 30 days: Z = 1.42, P > 0.05) or ECC Loss % (7 days: Z = 0.24, P > 0.05; 30 days: Z = 0.06, P > 0.05; 90 days: Z = 0.10, P > 0.05) between MICS and SICS. However, statistically significant differences were found in AVE (Z = 4.19, P < 0.0001) and SIA (1 day: Z = 10.33, P < 0.00001; 7 days: Z = 10.71, P < 0.00001; 30 days: Z = 10.95, P < 0.00001; 90 days: Z = 2.21,- P < 0.01) between MICS and SICS.

CONCLUSION

Compared with SICS, MICS can reduce short-term and long-term SIA, but it does not differ in safety outcomes or in the time required for surgery.

摘要

背景

切口大小在白内障手术疗效中起着关键作用，但关于理想切口大小的现有证据并不一致。在本研究中，我们进行了一项荟萃分析，以评估同轴微切口超声乳化手术（MICS）与标准切口超声乳化手术（SICS）治疗年龄相关性白内障患者的疗效。

方法

检索考克兰图书馆（Wiley在线图书馆）、PubMed、Medline、中国知网（CNKI）和维普数据库，以识别比较MICS与SICS治疗年龄相关性白内障的临床随机对照试验（RCT）报告。感兴趣的结局包括手术诱导散光（SIA）、有效超声乳化时间（EPT）、中央角膜厚度（CCT）、内皮细胞计数（ECC）、内皮细胞计数损失（ECC损失率）和平均超声能量（AVE）。

结果

本荟萃分析纳入了11项RCT研究。MICS与SICS在EPT（Z = 1.29，P > 0.05）、CCT（1天：Z = 1.37，P > 0.05；7天：Z = 0.75，P > 0.05；30天：Z = 0.38，P > 0.05；90天：Z = 0.29，P > 0.05）、ECC（7天：Z = 1.13，P > 0.05；30天：Z = 1.42，P > 0.05）或ECC损失率（7天：Z = 0.24，P > 0.05；30天：Z = 0.06，P > 0.05；90天：Z = 0.10，P > 0.05）方面未观察到统计学显著差异。然而，MICS与SICS在AVE（Z = 4.19，P < 0.0001）和SIA（1天：Z = 10.33，P < 0.00001；7天：Z = 10.71，P < 0.00001；30天：Z = 10.95，P < 0.00001；90天：Z = 2.21，P < 0.01）方面存在统计学显著差异。

结论

与SICS相比，MICS可降低短期和长期SIA，但在安全性结局或手术所需时间方面无差异。

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