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LASIK 治疗老视的疗效、安全性、可预测性和稳定性:系统评价和荟萃分析。

Efficacy, Safety, Predictability, and Stability of LASIK for Presbyopia Correction: A Systematic Review and Meta-analysis.

出版信息

J Refract Surg. 2023 Sep;39(9):627-638. doi: 10.3928/1081597X-20230802-02. Epub 2023 Sep 1.

Abstract

PURPOSE

To determine the efficacy, safety, predictability, and stability of laser in situ keratomileusis (LASIK) in the treatment of presbyopia.

METHODS

The databases of CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Registry, PubMed, The Cochrane Library, Web of Science, Embase, and ClinicalTrials.gov were searched until March 2023. The authors chose the studies of LASIK in the treatment of presbyopia. Outcomes were efficacy, safety, predictability, and stability. The review was registered in the international platform of registered systematic review and meta-analysis protocols (INPLASY202350005).

RESULTS

A total of 28 non-randomized controlled trials (15,861 eyes) were included. The results showed that after LASIK, (1) the distance efficacy decreased (mean difference [MD]: 0.02, 95% CI: 0.0 to 0.03, < .05) and the near efficacy increased (MD: -0.01, 95% CI: -0.19 to-0.02, < .05); (2) the distance safety decreased (MD: 0.07, 95% CI: 0.04 to 0.10, < .0001) and near safety increased (MD: -0.19, 95% CI: -0.39 to 0.02, > .05); (3) the predictability within ±1.00 and ±0.50 D was 94% (relative risk [RR]: 0.94, 95% CI: 0.90 to 0.98, < .001) and 80% (RR: 0.80, 95% CI: 0.74 to 0.86, < .001), respectively; and (4) 6 months postoperatively, the percentage of spherical equivalent changing within ±0.50 D was 95% (RR: 0.95, 95% CI: 0.89 to 0.99, < .001).

CONCLUSIONS

The near efficacy, predictability, and stability of LASIK for presbyopia correction were satisfactory; however, the distance efficacy and distance safety decreased. .

摘要

目的

评估 LASIK 治疗老视的疗效、安全性、可预测性和稳定性。

方法

检索中国知网、维普、万方、中国生物医学文献数据库、中国临床试验注册中心、PubMed、The Cochrane Library、Web of Science、Embase 和 ClinicalTrials.gov 数据库,检索时限均为建库至 2023 年 3 月。选择 LASIK 治疗老视的研究,观察指标为疗效、安全性、可预测性和稳定性。研究注册于国际系统评价和荟萃分析注册平台(INPLASY202350005)。

结果

共纳入 28 项非随机对照研究(15861 只眼)。结果显示:LASIK 术后,(1)远视力疗效降低(MD:0.02,95%CI:0.0 至 0.03, <.05),近视力疗效提高(MD:-0.01,95%CI:-0.19 至-0.02, <.05);(2)远视力安全性降低(MD:0.07,95%CI:0.04 至 0.10, <.0001),近视力安全性提高(MD:-0.19,95%CI:-0.39 至 0.02, >.05);(3)预测性±1.00 和±0.50 D 分别为 94%(RR:0.94,95%CI:0.90 至 0.98, <.001)和 80%(RR:0.80,95%CI:0.74 至 0.86, <.001);(4)术后 6 个月,等效球镜值±0.50 D 范围内的百分比为 95%(RR:0.95,95%CI:0.89 至 0.99, <.001)。

结论

LASIK 治疗老视的近视力疗效、可预测性和稳定性较好,但远视力疗效和远视力安全性降低。

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