小切口微透镜取出术和飞秒激光原位角膜磨镶术后的角膜生物力学：系统评价和荟萃分析。

Corneal biomechanics after small incision lenticule extraction and femtosecond laser in situ keratomileusis: A systematic review and meta-analysis.

机构信息

Aier Huangpi Eye Hospital, Wuhan, Hubei Province, China.

Zhengzhou Aier Eye Hospital, Zhengzhou, Henan Province, China.

出版信息

Medicine (Baltimore). 2023 Aug 11;102(32):e34580. doi: 10.1097/MD.0000000000034580.

DOI:10.1097/MD.0000000000034580

PMID:37565903

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10419641/

Abstract

BACKGROUND

Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) have been extensively studied as the main surgical methods for corneal refractive surgery. However, there is no consensus on whether SMILE is superior to FS-LASIK in corneal biomechanics. Therefore, this systematic review and meta-analysis used the results of ocular response analyzer and corvis ST to explore whether SMILE is superior to FS-LASIK in corneal biomechanics.

METHODS

The literature was searched in PubMed, EMBASE, and Controlled Trials Register databases. The Cochrane Collaboration's "risk of bias" tool was used to evaluate the quality of the included randomized clinical trials, and the Newcastle-Ottawa Scale was used to evaluate the included non-randomized controlled trials. The results were analyzed using Revman 5.3.

RESULTS

Sixteen studies (3 randomized clinical trials and 13 non-randomized controlled trials) were included in this meta-analysis. There was no statistical difference in corneal biomechanics between SMILE and FS-LASIK in corneal hysteresis [mean difference (MD), 0.20; 95% confidence interval (CI): -0.09, 0.49; P = .18] and corneal resistant factor (MD, 0.31; 95% CI: -0.09, 0.71; P = .13), A1 time (MD, -0.02; 95% CI: -0.11, 0.07; P = .66), A1 length (MD, 0.01; 95% CI: -0.01, 0.03; P = .42), A1 velocity (MD, 0.00; 95% CI: -0.01, 0.01; P = .85), A2 velocity (MD, -0.01; 95% CI: -0.11, 0.09; P = .86), HC time (MD, 0.12; 95% CI: -0.13, 0.38; P = .35), The stiffness parameter at first applanation (MD, -7.91; 95% CI: -17.96, 2.14; P = .12), The ratio between the deformation amplitude 2 mm away from apex and the apical deformation (MD, 0.01; 95% CI: -0.26, 0.27; P = .96).

CONCLUSION

A comprehensive assessment of the parameters of ocular response analyzer and corvis ST showed that SMILE is not superior to LASIK in corneal biomechanics 3 months post-surgery.

摘要

背景

小切口微透镜提取术（SMILE）和飞秒激光原位角膜磨镶术（FS-LASIK）已被广泛研究作为角膜屈光手术的主要手术方法。然而，SMILE 在角膜生物力学方面是否优于 FS-LASIK 尚无定论。因此，本系统评价和荟萃分析使用眼反应分析仪和 Corvis ST 的结果来探讨 SMILE 在角膜生物力学方面是否优于 FS-LASIK。

方法

在 PubMed、EMBASE 和对照试验登记数据库中检索文献。使用 Cochrane 协作“偏倚风险”工具评估纳入的随机临床试验的质量，并使用纽卡斯尔-渥太华量表评估纳入的非随机对照试验。使用 Revman 5.3 进行结果分析。

结果

荟萃分析纳入了 16 项研究（3 项随机临床试验和 13 项非随机对照试验）。SMILE 和 FS-LASIK 在角膜滞后[平均差值（MD），0.20；95%置信区间（CI）：-0.09，0.49；P =.18]和角膜阻力因子（MD，0.31；95%CI：-0.09，0.71；P =.13）、A1 时间（MD，-0.02；95%CI：-0.11，0.07；P =.66）、A1 长度（MD，0.01；95%CI：-0.01，0.03；P =.42）、A1 速度（MD，0.00；95%CI：-0.01，0.01；P =.85）、A2 速度（MD，-0.01；95%CI：-0.11，0.09；P =.86）、HC 时间（MD，0.12；95%CI：-0.13，0.38；P =.35）、首次压平的刚性参数（MD，-7.91；95%CI：-17.96，2.14；P =.12）、距顶点 2mm 处的变形幅度与顶点变形之间的比值（MD，0.01；95%CI：-0.26，0.27；P =.96）等参数无统计学差异。