Yao Lin, Zhang Minghong, Wang Dianqiang, Zhao Qian, Wang Shouyan, Bai Haiqing
Qingdao Aier Eye Hospital, Qingdao, SD, China.
Yantai Aier Eye Hospital, Yantai, SD, China.
Semin Ophthalmol. 2023 Apr;38(3):283-293. doi: 10.1080/08820538.2022.2107399. Epub 2022 Jul 31.
The purpose of this meta-analysis is to systematically compare the safety, efficacy, and predictability of small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).
This study covered the data searched from the PubMed, the EMBASE and the Cochrane Library. The Cochrane Handbook was also referred to as evaluating the quality of the included studies. In addition, this meta-analysis was performed using Revman 5.4 software.
A total of 11 randomized controlled trails (RCTs) were included. The proportion of eyes with refraction within ±0.5D was higher in LASIK group compared with SMILE group (RR, 0.91; 95% CI, 0.83 to 0.99; = .04). The spherical aberration (SA) was smaller in SMILE group compared with LASIK group (RR, -0.12; 95% CI, -0.23 to -0.01; = .04). There were no significant differences between two groups with regard to final mean refractive spherical equivalent (SE) (MD, -0.04; 95% CI, -0.12 to 0.03; p = .22), proportion of eyes losing one or more lines of corrected distance visual acuity (CDVA) (RR, 1.14; 95% CI, 0.58 to 2.27; p = .70), proportion of eyes with uncorrected distance visual acuity (UCVA) of 20/20 or better (RR, 0.99; 95% CI, 0.94 to 1.05; p = .71), postoperative mean logMAR UCVA (MD, 0.01; 95% CI, -0.00 to 0.03; p = .13), postoperative refraction within ±1.0D (RR, 1.00; 95% CI, 0.98 to 1.02; p = .60), postoperative astigmatism within ±0.25, 0.5 and 1.0D (RR, 0.80, 0.99, 1.00; 95% CI, 0.35 to 1.83, 0.94 to 1.05, 0.98 to 1.02; p = .60, 0.86, 0.87), postoperative higher order aberrations (HOAs) (RR, 0.00; 95% CI, -0.16 to 0.16; p = .99).
For predictability, LASIK was superior to SMILE. There were comparably safety and efficacy for the correction of myopia and myopic astigmatism in SMILE and LASIK. SA was smaller after SMILE than after LASIK.
本荟萃分析旨在系统比较小切口飞秒激光基质透镜切除术（SMILE）和准分子原位角膜磨镶术（LASIK）的安全性、有效性和可预测性。
本研究涵盖了从PubMed、EMBASE和Cochrane图书馆检索到的数据。还参考了Cochrane手册来评估纳入研究的质量。此外，本荟萃分析使用Revman 5.4软件进行。
共纳入11项随机对照试验（RCT）。与SMILE组相比，LASIK组中屈光在±0.5D范围内的眼睛比例更高（风险比[RR]，0.91；95%置信区间[CI]，0.83至0.99；P = 0.04）。与LASIK组相比，SMILE组的球差（SA）更小（RR，-0.12；95% CI，-0.23至-0.01；P = 0.04）。两组在最终平均等效球镜度（SE）（平均差[MD]，-0.04；95% CI，-0.12至0.03；P = 0.22）、矫正视力（CDVA）下降一行或多行的眼睛比例（RR，1.14；95% CI，0.58至2.27；P = 0.70）、裸眼视力（UCVA）为20/20或更好的眼睛比例（RR，0.99；95% CI，0.94至1.05；P = 0.71）、术后平均logMAR UCVA（MD，0.01；95% CI，-0.00至0.03；P = 0.13）、术后屈光在±1.0D范围内（RR，1.00；95% CI，0.98至1.02；P = 0.60）、术后散光在±0.25D、0.5D和1.0D范围内（RR，0.80、0.99、1.00；95% CI，0.35至1.83、0.94至1.05、0.98至1.02；P = 0.60、0.86、0.87）、术后高阶像差（HOAs）（RR，0.00；95% CI，-0.16至0.16；P = 0.99）方面无显著差异。
在可预测性方面，LASIK优于SMILE。SMILE和LASIK在矫正近视和近视散光方面具有相当的安全性和有效性。SMILE术后的SA比LASIK术后更小。
