飞秒激光辅助白内障手术与传统超声乳化白内障手术的疗效和安全性比较:系统综述和荟萃分析。

IF 3.3 4区 医学 Q1 OPHTHALMOLOGY
Xinzhi Song, Ling Li, Xuemei Zhang, Jianjun Ma
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引用次数: 0

摘要

目的研究飞秒激光辅助白内障手术(FLACS)与传统超声乳化白内障手术(CPCS)相比的有效性和安全性:在PubMed、Embase、Cochrane Library、ClinicalTrials.gov、CNKI和万方数据库中系统检索了随机对照试验(RCT)。主要结果包括视力、囊切参数、有效晶状体位置和并发症。次要结果包括屈光结果、术中参数和角膜参数:结果:共纳入了 41 项 RCT,涉及 9310 只眼睛。在 12 个月的未矫正远距离视力(平均差 [MD] -0.03;95% CI -0.05至-0.01)、1 周的矫正远距离视力(MD -0.05;95% CI -0.07至-0.02)和 12 个月的矫正远距离视力(MD -0.02;95% CI -0.04至-0.00)、囊膜面积(MD -0.05;95% CI -0.07至-0.02)、角膜曲率(MD -0.01)、角膜曲率(MD -0.01)和角膜曲率(MD -0.01)方面,FLACS优于CPCS,差异有统计学意义。00);1个月(MD为4.04平方毫米;95% CI为3.45-4.64)和6个月(MD为5.02平方毫米;95% CI为3.28-6.77)的囊切面积;1周(MD为-0.06毫米;95% CI为-0.08--0.05)、1个月(MD为-0.07毫米;95% CI为-0.09--0.06)和6个月(MD为-0.06毫米;95% CI为-0.07--0.04)的眼内晶状体中心点-瞳孔中心点距离。在手术并发症方面,FLACS的人工晶体脱落发生率低于CPCS(几率比0.06;95% CI 0.01-0.24)。然而,除结膜下出血外,FLACS 并未增加其他术中或术后并发症的发生率:结论:FLACS 和 CPCS 均有效且安全。结论:FLACS 和 CPCS 都是有效和安全的,FLACS 在术后早期和长期随访中获得了更好的视觉效果,同时,与 CPCS 相比,FLACS 的囊袋切除更准确,有效晶状体位置更优化。然而,中期随访后发现两者的视觉效果并无差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the efficacy and safety between femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery: systematic review and meta-analysis.

Objective: To investigate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) compared with conventional phacoemulsification cataract surgery (CPCS).

Methods: Randomized controlled trials (RCTs) were systematically searched in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, and Wanfang. Main outcomes were visual acuity, capsulotomy parameters, effective lens position, and complications. Secondary outcomes included refractive outcomes, intraoperative parameters, and corneal parameters.

Results: In total, 41 RCTs involving 9310 eyes were included. There was a statistically significant difference in favour of FLACS over CPCS for uncorrected distance visual acuity at 12 months (mean difference [MD] -0.03; 95% CI -0.05 to -0.01); corrected distance visual acuity at 1 week (MD -0.05; 95% CI -0.07 to -0.02) and 12 months (MD -0.02; 95% CI -0.04 to -0.00); area of capsulotomy at 1 month (MD 4.04 mm2; 95% CI 3.45-4.64) and 6 months (MD 5.02 mm2; 95% CI 3.28-6.77); and intraocular lens centroid-pupil centroid distance at 1 week (MD -0.06 mm; 95% CI -0.08 to -0.05), 1 month (MD -0.07 mm; 95% CI -0.09 to -0.06), and 6 months (MD -0.06 mm; 95% CI -0.07 to -0.04). With regard to surgical complications, FLACS was less than CPCS for the incidence of decentred IOL (odds ratio 0.06; 95% CI 0.01-0.24). However, FLACS did not increase the incidence of other intraoperative or postoperative complications except subconjunctival hemorrhage.

Conclusions: Both FLACS and CPCS are effective and safe. FLACS achieves better visual outcomes in the early postoperative period and long-term follow-up, accompanied by more accurate capsulotomy and more optimized effective lens position than CPCS. However, no difference of visual outcomes was found after middle-term follow-up.

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来源期刊
CiteScore
3.20
自引率
4.80%
发文量
223
审稿时长
38 days
期刊介绍: Official journal of the Canadian Ophthalmological Society. The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.
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