囊袋张力环维持人工晶状体稳定性效果的Meta分析

目的评价囊袋张力环(CTR)对维持常规白内障术后人工晶状体(IOL)稳定性的效果。 方法利用计算机检索中国知网及生物医学文献数据库、万方数据库、维普数据库、PubMed、Medline及Cochrane Library,搜集CTR应用于维持白内障术后IOL的相关文献。采用Cochrane系统评价的方法,由两位评价者独立进行文献检索、筛选、质量评价及数据提取。从选取的研究中提取术后IOL的旋转度、未矫正视力(UCVA)以及残余散光度。采用均数差(MD)及其95%置信区间(CI)表示计量资料的效应量。文献研究间的异质性评价,采用Q检验和I²检验。如P<0.05或I²>50%则认为异质性较大,采用随机效应模型进行分析;反之,采用固定效应模型进行分析。 结果在各数据库初步检索到文献1253篇。去除重复、内容不相符或者主要结局指标不完善、非随机对照试验(RCT)及数据不能提取的文献,最终纳入本研究文献4篇。其中,包括153只眼植入CTR与156只眼未植入CTR。经Meta分析,发现白内障常规手术植入CTR可降低IOL的术后旋转度,提高IOL的稳定性。经随机效应模型分析,两者比较的差异具有统计学意义(MD＝-0.81,95%CI：-1.46~-0.15,P<0.05)。白内障常规手术植入CTR与患者术后UCVA的比较,差异无统计学意义(MD＝0.02,95%CI：-0.01~0.05,P>0.05);CTR植入与术后残余散光度的比较,差异无统计学意义(MD＝-0.14,95%CI：-0.33~0.05,P>0.05)。 结论白内障常规手术植入CTR可降低IOL的术后旋转度,增加其稳定性,但对术后UCVA以及残余散光度均无明显影响。应用CTR提高散光矫正型IOL的稳定性仍待商榷。

Meta-analysis of the outcome of stability of intraocular lens with capsular tension ring

ObjectiveThe aim of this study was to systematically evaluate the stability outcome of intraocular lens (IOL) with and without capsular tension ring (CTR). MethodsA literature search was implemented in CNKI, Wanfang Data, VIP Data, PubMed, Medline and Cochrane Library, related literatures were collected. Using the evaluation method of Cochrane system, two reviewers independently performed literature search, screening, quality evaluation, and data extraction. The data including the degrees of postoperative rotation, uncorrected visual acuity (UCVA) and residual astigmatism were analyzed. The mean difference (MD) and a confidence interval (CI) of 95% were used to describe the effect sizes of continuous data. Heterogeneity was examined by Q test and I² statistics. When P<0.05 or I²>50% was examined using a random effects model. Otherwise, the fixed effects model was performed. ResultsIn each database, 1253 literatures were retrieved. After excluding the repetitive literatures, the literatures with inconsistent contents or incomplete main outcome indicators, the literatures without randomized controlled trials (RCT) research and the literatures with data that cannot be extracted, there are 4 literatures included in this study. Among of them, there were 153 eyes with CTR and 156 eyes without CTR. Meta-analysis results showed that with CTR showed statistically relevant difference in the overall effect of maintaining the stability of IOL using the random effects model (MD=-0.81, 95%CI: -1.46~-0.15, P<0.05). There were showed no significant difference between the UCVA and whether or not using CTR (MD=0.02, 95%CI: -0.01~0.05, P>0.05); non-significant difference between residual astigmatism and whether or not using CTR (MD=-0.14; 95%CI: -0.33~0.05, P>0.05) . ConclusionsCTR could reduce the degrees of postoperative IOL rotation. No significant differences were founded in posto-perative UCVA and residual astigmatism between with or without CTR groups. It is nessary to carry out more researches to demonstrate the great application of CTR on promoting the stability of Toric IOL.