后囊环形切除及其联合前段玻璃体切除术对后发性白内障影响的Meta分析

目的 系统评价白内障超声乳化吸除术中选择Ⅰ期后囊环形切除（PCCC）与选择Ⅰ期后囊环形切除联合前段玻璃体切除（PCCC＋AV）对患者后发性白内障的影响。设计 基于文献检索的Meta分析。研究对象 检索MEDLINE数据库、中国期刊网专题全文数据库、中文生物医学文献数据库、维普中文科技期刊数据库、中国医学学术会议论文、中国优秀硕博士论文数据库、超星数字图书馆、书生之家数字图书馆等；手工检索国内外相关教科书、会议论文等；并以所有检出文献的参考文献作为补充。方法 严格按照纳入、排除标准筛选文献，并对纳入文献进行质量评估，提取研究所需信息。数据分析选用Review Manager 4．2．2软件、SPSS10．0软件，检验异质性，根据检验结果选择相应的效应模型进行Meta分析，以优势比（OR）判定PCCC术式和PCCC＋AV术式对患者后发性白内障的影响，并改变选择的效应模型，计算失效安全数（Nfs）进行敏感性分析。主要指标 纳入研究的文献异质性，研究结果的敏感性，95％置信区间（CI）及Nfs。结果 6篇文献共计305例白内障患者。经异质性检验，纳入文献无异质性，选择固定效应模型计算OR值。后发性白内障PCCC组与PCCC＋AV组的合并OR值为0．13（95％CI：0．06～0．25），差异有统计学意义（P〈0．000）。改用随机效应模型计算OR值，进行敏感性分析，差异仍有统计学意义（P〈0．000），且Nfs=76．8，纳入文献稳定性好。结论 白内障超声乳化吸除术中选择Ⅰ期PCCC＋AV术式患者较术中单纯选择I期PCCC术式的患者更能有效抑制后发性白内障的发生。

Influence of the phacoemulsification with posterior continuous curvilinear capsulorhexis and anterior vitrectomy on after cataract: a Meta-analysis

Objective To evaluate the functional outcomes of the phacoemulsification(Phaco)with posterior continuous curvilinear capsulorhexis(PCCC),or with PCCC and anterior vitrectomy(AV)on after cataract.Design Meta analysis based on the reference searching.Participants A comprehensive electric search in MEDLINE,CNKI,CBMdisc,VIP information,CMCC,CCPD,SSreader,21dmedia and a manual search in related textbooks,journals,congress articles and their references in English and Chinese.Methods Strictly include and exclude the relevant articles from the resource with statistical criterion and get the needing data.Statistically analysed the data with software of Review Manager4.2.2,SPSS10.0.Heterogeneity of the included articles was tested that used to select appropriate effect model to Meta-analysis.Treatment effect was measured as odds ratio between Phaco with PCCC group and Phaco with PCCC AV group.Change the selected effect model and calculate the fail-safe number(Nfs)to assess the sensitivity and specificity of the research.Main Outcome Measures Sensitivity,heterogeneity,the according confidence intervals(CI)and Nfs.Results Six studies were included,with a sum of 305 eyes.With the outcomes of heterogeneity test,the fixed effect model was used in both groups to calculate OR.The pooled OR of after cataract was 0.13(95%CI is 0.06-0.25).Sensitivity analysis demonstrated that no disproportionate influences of individual study.And Nfs=76.8,the result was confirmed.Conclusion Phacoemulsification with posterior continuous curvilinear capsulorhexis and anterior vitrectomy is superior to phacoemulsification with posterior continuous curvilinear capsulorhexis on preventing after cataract.