白内障手术中陡峭轴切口与非陡峭轴切口矫正术前散光比较的meta分析  

Comparison of steep-axis incision and non-steep-axis incision for the correction of preexisting corneal astigmatism during cataract surgery:a meta-analysis

作　　者：陆强 竺向佳 卢奕 LU Qiang;ZHU Xiangjia;LU Yi(Department of Ophthalmology,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2021年第5期367-374,共8页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的采用meta分析的方法系统评价白内障手术中行陡峭轴切口矫正术前散光的治疗效果。方法meta分析。应用Review Manager 5.3软件,评估术后散光、手术前后散光屈光度改变量、术后裸眼视力和术后最佳矫正视力等效应量。结果最终纳入15篇文献,共计1213眼,其中包括接受陡峭轴角膜切口531眼,接受非陡峭轴角膜切口682眼。meta分析结果显示陡峭轴切口组术后残余散光小于非陡峭轴切口组,平均差(MD):-0.29;95%置信区间(95%CI):[-0.36,-0.22];P<0.001。与非陡峭轴切口相比,陡峭轴切口能显著减小术前角膜散光,MD:-0.33;95%CI:[-0.41,-0.26];P<0.001。陡峭轴切口组术后裸眼视力显著高于非陡峭轴切口组,MD:-0.06;95%CI:[-0.10,-0.01];P=0.01,但最佳矫正视力无差异,MD:-0.03;95%CI:[-0.07,0.00];P=0.06;1-β=0.96。结论与非陡峭轴切口相比,白内障手术陡峭轴切口能更好地矫正患者术前角膜散光和提高患者术后裸眼视力,值得在中低度散光白内障患者群体中广泛推广。Objective To systematically compare the effects of steep-axis incision and non-steep-axis incision on the correction of pre-existing astigmatism during cataract surgery.Methods Postoperative astigmatism,change in cylinder power caused by cataract surgery,postoperative uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)were pooled and analyzed by Review Manager 5.3.Results We included 15 studies with 1213 eyes randomized to steep-axis and non-steep axis incision during cataract surgery.According to the meta-analysis,postoperative astigmatism was significantly lower in eyes with steep-axis incision[mean difference(MD):-0.29;95%confidence interval(CI):[-0.36,-0.22];P<0.001],with non-steep-axis incision better at decreasing preexisting astigmatism(MD:-0.33;95%CI:[-0.41,-0.26];P<0.001).UCVA was better in the steep-axis group(MD:-0.06;95%CI:[-0.10,-0.01];P=0.01),while no difference was found in BCVA between the two groups postoperatively(MD:-0.03;95%CI:[-0.07,0.00];P=0.06;1-β=0.96).Conclusions Compared with non-steep-axis incision,steep-axis incision in cataract surgery could lower the amounts of residual astigmatism more prominently and provide better UCVA.The current evidence suggests a more extensive practice of steep-axis incision in cataract surgery.

关 键 词：白内障手术 陡峭轴 散光 META分析 

分 类 号：R779.66[医药卫生—眼科]