双手微小切口与传统同轴超声乳化吸除术对术后视觉质量影响的Meta分析  

Effect of bimanual microincisional cataract surgery versus conventional coaxial small-incision cataract surgery on visual quality： A meta-analysis

作　　者：苏琪[1] 宋秀君[1] 

机构地区：[1]河北医科大学第三医院眼科,河北石家庄050051

出　　处：《中华眼视光学与视觉科学杂志》2010年第3期209-213,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的系统评价双手微小切VI（B—MICS）与传统同轴白内障超声乳化吸除术（C—SICS）对术后视觉质量的影响。方法通过计算机文献检索，结合手工检索，对纳入的有关B—MICS和C—SICS临床疗效的相关文献进行Meta分析，以比值比（OR）和加权均数差值（WMD）为效应量，应用Review Manager4．2软件进行Meta分析。对检索所得资料进行敏感性分析，并评价其发表偏倚。结果共有9篇文献纳入研究。术后1d、1周、1个月，裸眼视力≥0．5的合并OR值分别为1．82（95％凹：1.38～2．39）、2．36（95％CI：1．27-4．37）和1．61（95％CI：1．08—2．41）。术后1个月，手术源性散光合并WMD值为一0-35D（95％CI：-0．48—0．21D），差异有统计学意义（P〈0．01）。术后1个月，最佳矫正视力／〉0．5的合并OR值为1．69（95％CI：0．93～3．07），差异无统计学意义。敏感性分析及发表性偏倚结果显示本研究结果具有较好稳定性。结论B—MICS可减少手术源性散光．使患者术后视力恢复得更快、更好。Objective To evaluate the efficacy of bimanual microincisional cataract surgery （B-MICS） versus conventional coaxial small-incision cataract surgery （C-SICS） for visual quality. Methods A systematic review of B-MICS and C-SICS was conducted by a computer search on Medline, EMCC, OVID, and CNKI and a supplementary manual search was also done. The effect was measured as an odds ratio （OR） and weighted mean difference （WMD）. Review manager 4.2 software was used to perform the meta-analysis. A sensitivity analysis was then performed and a publication bias was evaluated by a funnel plot and Egger＇s regression test. Results Only relevant articles from the resource material were included and/or excluded using a strict criterion. A total of 9 articles were included in the meta-analysis. The ORs of naked visual acuity 0.5 or better at 1 day, 1 week, and 1 month after surgery were 1.82 （95%CI was 1.38-2.39）, 2.36 （95%CI was 1.27-4.37） and 1.61 （95% CI was 1.08-2.41）, respectively. The differences were statistically significant （P〈0.05）. The OR of the best corrected visual acuity 0.5 or better at 1 month after surgery was 1.69 （95%CI was 0.93-3.07）, but there was no statistically significant difference （P〉0.05）. A summary WMD of the meta-analysis showed a significant reduction in surgically induced astigmatism in the B-MICS group （WMD=-0.35 D, 95%CI： -0.48-0.21 D, P〈0.01）. Sensitivity analysis and publication bias showed that the outcomes of this research were stable and reliable. Conclusion The evidence currently available showed that B-MICS is a safer and more reliable surgery for restoration of visual acuity and reducing surgically induced astigmatism in patients with cataract.

关 键 词：双手微小切口 超声乳化白内障吸除术 视力 散光 META分析 

分 类 号：R779.66[医药卫生—眼科]