Liu Yuanyuan, Cai Qinhua
Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu 215006, China.
J Ophthalmol. 2020 Sep 27;2020:7863987. doi: 10.1155/2020/7863987. eCollection 2020.
Cataract and age-related macular degeneration (AMD) are the common causes of blindness in the elderly. Although cataract surgery is the most effective treatment for cataract, some clinicians suspect that such interventions may accelerate the progression of AMD. Therefore, we carried out this meta-analysis to focus on demonstrating the effectiveness and safety of cataract surgery in eyes with AMD.
We performed a systematic literature search in the PubMed, EMBASE, and Cochrane Library databases, and the electronic databases were last searched in January 2019. We planned to include cohort trials of eyes affected by both cataract and AMD in which cataract surgery would be compared to no surgery. Two reviewers independently evaluated the search results against the inclusion and exclusion criteria. 8 trials were included for this meta-analysis.
We used the Stata/12.0 to integrate the data that was extracted from the articles. Eight cohort trials with data from different study populations were included. In random effects model, the relative risk (RR) for the progression of AMD is 1.194 (95% CI 0.897-1.591). As for those grouped according to the follow-up year, the RR for longer than five years was 1.372 (95% CI 1.062-1.772).
We could draw out such a conclusion that there is still a positive correlation between cataract surgery and the progression of AMD, especially for the Asians. However, based on the current results, it is not possible to draw conclusions from existing studies on the impact of cataract surgery on early AMD development.
白内障和年龄相关性黄斑变性（AMD）是老年人失明的常见原因。尽管白内障手术是治疗白内障最有效的方法，但一些临床医生怀疑这种干预可能会加速AMD的进展。因此，我们进行了这项荟萃分析，以重点证明白内障手术在患有AMD的眼中的有效性和安全性。
我们在PubMed、EMBASE和Cochrane图书馆数据库中进行了系统的文献检索，电子数据库的最后一次检索时间为2019年1月。我们计划纳入白内障和AMD均受累的眼睛的队列试验，其中将白内障手术与未手术进行比较。两名 reviewers 独立根据纳入和排除标准评估检索结果。本荟萃分析纳入了8项试验。
我们使用Stata/12.0整合从文章中提取的数据。纳入了8项来自不同研究人群的数据的队列试验。在随机效应模型中，AMD进展的相对风险（RR）为1.194（95%CI 0.897-1.591）。至于按随访年份分组的那些，超过五年的RR为1.372（95%CI 1.062-1.772）。
我们可以得出这样的结论，白内障手术与AMD的进展之间仍然存在正相关，尤其是对亚洲人而言。然而，基于目前的结果，不可能从现有研究中得出关于白内障手术对早期AMD发展影响的结论。
