郭刚, 洪剑威, 邓庆昌. Toric人工晶状体植入治疗合并角膜散光的白内障临床疗效的Meta分析[J]. 循证医学, 2018, 18(3): 181-188. DOI: 10.12019/j.issn.1671-5144.2018.03.011
    引用本文: 郭刚, 洪剑威, 邓庆昌. Toric人工晶状体植入治疗合并角膜散光的白内障临床疗效的Meta分析[J]. 循证医学, 2018, 18(3): 181-188. DOI: 10.12019/j.issn.1671-5144.2018.03.011
    GUO Gang, HONG Jian-wei, DENG Qing-chang. Meta-Analysis on Toric Intraocular Lens for Cataract and Corneal Astigmatism[J]. Journal of Evidence-Based Medicine, 2018, 18(3): 181-188. DOI: 10.12019/j.issn.1671-5144.2018.03.011
    Citation: GUO Gang, HONG Jian-wei, DENG Qing-chang. Meta-Analysis on Toric Intraocular Lens for Cataract and Corneal Astigmatism[J]. Journal of Evidence-Based Medicine, 2018, 18(3): 181-188. DOI: 10.12019/j.issn.1671-5144.2018.03.011

    Toric人工晶状体植入治疗合并角膜散光的白内障临床疗效的Meta分析

    Meta-Analysis on Toric Intraocular Lens for Cataract and Corneal Astigmatism

    • 摘要: 目的 系统评价散光型Toric人工晶状体矫正白内障合并角膜散光的临床效果及对视功能的影响。 方法 计算机检索PubMed、EMBASE、Cochrane图书馆、中国知网、万方、维普数据库,搜集有关Toric人工晶状体治疗白内障合并角膜散光的相关文章,由2位评价者独立进行文献检索、筛选文献、资料提取和质量评价,选择裸眼远视力、最佳矫正远视力、残余散光作为观察指标,采用 RevMan 5.3软件进行Meta分析。 结果 最终纳入18篇文献,共计1 761例患者1 923眼。Meta分析结果显示: 与传统人工晶状体植入或传统人工晶状体植入联合松解切口相比,Toric人工晶状体治疗白内障合并角膜散光具有更好的远期裸眼远视力(LogMRA)(均数差=-0.07,95%可信区间-0.10~-0.04, P<0.000 1);Toric人工晶状体植入的患者中远期裸眼远视力无法达到20/25视力的患者比例更低(比值比=0.32,95%可信区间0.24~0.43,P<0.000 1),最佳矫正远视力无法达到20/25视力的患者比例也更低(比值比=0.58,95%可信区间0.41~1.01,P=0.05);植入Toric人工晶状体组残余散光度数低于传统人工晶状体组(均数差=-0.49,95%可信区间-0.69~-0.30, P<0.000 01)。 结论 与传统人工晶状体相比,Toric人工晶状体在提高患者术后视觉质量、减少残余散光方面有较大的优势。

       

      Abstract: Objective To clarify the effect of Toric intraocular lens (IOL) in the treatment of cataract and corneal astigmatism by meta-analysis. Methods The PubMed, EMBASE, Cochrane library, CNKI, Wanfang, and VIP database were searched for studies investigating the effect of Toric IOL in the treatment of cataract and corneal astigmatism. Meta-analysis was performed using RevMan 5.3 software to analyze the uncorrected distant visual acuity (UCDVA), best corrected distant visual acuity (BCDVA), and residual astigmatism between Toric IOL and traditional IOL. Results A total of 18 studies including 1 761 patients (1 923 eyes) were included. The pooled MD of -0.07(95%CI -0.10~ -0.04, P<0.000 1)showed that patients received Toric IOL implantation have better UCDVA. Pooled of seven studies evaluating the percentage of patients reaching UCDVA 20/25 revealed a OR of 0.32 (95%CI 0.24~0.43,P<0.000 1), suggesting patients with Toric IOL implantation have decreased risk of can not reach 20/25 UCDVA; in addition, the pooled of three studies reported a decreased risk patients with Toric IOL implantation in terms of can not reaching BCDVA 20/25 (OR=0.58,95%CI 0.41~1.01,P=0.05); at last, pooled analysis of fourteen studies revealed that patients with Toric IOL implantation have significantly improved corneal astigmatism (MD=-0.49,95%CI -0.69~-0.30, P<0.000 01). Conclusion Toric IOL is effective in the treatment of cataract and corneal astigmatism with ideal postoperative distant visual acuity and decreased degree of corneal astigmatism.

       

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