飞秒激光制瓣的LASIK与SMILE术后角膜敏感性变化的Meta分析

doi:10.3760/cma.j.issn.1674-845X.2014.07.011

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摘要

目的系统评价飞秒激光制瓣的LASIK（FS-LASIK）和SMILE治疗近视术后角膜敏感性的差异。方法 Meta分析。采用严密设计的检索策略检索Medline、Cochrane图书馆、中国生物医学文献数据库（CBM disc）、中国期刊全文数据库（CNKI），对比较FS-LASIK和SMILE术后角膜敏感性的文献进行Meta分析。分析内容主要包括术前，术后1周、1个月、3个月及6个月的中央角膜敏感性。采用RevMan 5.0进行统计分析，计量资料以加权均数差（WMD）（95％CI）为疗效分析统计量。对检索文献的证据等级按照Jadad量表进行评价。结果共有4篇文献符合本研究的纳入标准，共198例（316眼）。Meta分析结果显示：术前FS-LASIK和SMILE中央角膜敏感性差异无明显统计学意义（WMD=0.28，95％CI：-0.73~1.29，P>0.05）；然而，术后1周、1个月、3个月及6个月两者差异均有明显统计学意义（WMD=-14.56，95％CI：-23.79~-5.34，P<0.01；WMD=-15.29，95％CI：-22.46~-8.11，P<0.01；WMD=-13.12，95％CI：-18.77~-7.46，P<0.01；WMD=-3.45，95％CI：-5.72~-1.18，P<0.01）。结论与FS-LASIK相比，SMILE术后角膜敏感性下降幅度可能更小，恢复更快；术后6个月时，SMILE术后角膜敏感性仍高于FS-LASIK。

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	金男
	方一明
	李晓霞
	姚鹏翔
	王振亮
	蒋建伟

关键词 ：角膜磨镶术, 激光原位, 飞秒激光, 飞秒激光小切口基质透镜取出术, 角膜敏感性, Meta分析, 循证医学

Abstract：

Objective To evaluate and compare corneal sensitivity after Femtosecond LASIK （FS-LASIK） and small incision lenticule extraction （SMILE） from a systematic review of literature. Methods This was a meta-analysis study. A systematic literature retrieval was conducted in Medline， the Cochrane Library， CBM disc， and CNKI. Central corneal sensitivity after FS-LASIK and SMILE was compared by meta-analysis， including pre-operation， 1 week， 1 month， 3 months and 6 months post-operation. A statistical analysis was performed using RevMan 5.0 software. Weighted mean difference （WMD）（95%CI） was used to analyze continuous variables. The quality of the included literature was scored according to the Jadad scale. Results A total of 4 studies with a total of 198 patients （316 eyes） in the literature met the inclusion criteria Meta analysis results showed that there was no difference in central corneal sensitivity between FS-LASIK and SMILE before surgery （WMD=0.28， 95％CI： -0.73~1.29， P>0.05）； however， 1 week， 1 month， 3 months and 6 months after surgery， corneal sensitivity after SMILE was significantly higher than after FS-LASIK （WMD=-14.56， 95％CI： -23.79~-5.34， P<0.01； WMD=-15.29， 95％CI： -22.46~-8.11， P<0.01； WMD=-13.12， 95％CI： -18.77~-7.46， P<0.01； WMD=-3.45， 95％CI： -5.72~-1.18， P<0.01）. Conclusion Compared with FS-LASIK， central corneal sensitivity after SMILE has a smaller decrease and faster recovery. Corneal sensitivity after SMILE is still higher than FS-LASIK during the 6-month period after surgery.

Key words： Keratomileusis laser in situ femtosecond laser Small incision lenticule extraction Corneal sensitivity Meta analysis Evidence-based medicine

通讯作者: 方一明，Email：fymeye@qzeye.net

引用本文:

金男,方一明,李晓霞,姚鹏翔,王振亮,蒋建伟. 飞秒激光制瓣的LASIK与SMILE术后角膜敏感性变化的Meta分析[J]. 中华眼视光学与视觉科学杂志, 2014, 16(7): 430-435. Jin Nan,Fang Yiming,Li Xiaoxia,Yao Pengxiang,Wang Zhenliang,Jiang Jianwei. Meta-analysis of corneal sensitivity after femtosecond LASIK and SMILE surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2014, 16(7): 430-435. DOI: 10.3760/cma.j.issn.1674-845X.2014.07.011

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https://www.cjoovs.com/CN/10.3760/cma.j.issn.1674-845X.2014.07.011 或 https://www.cjoovs.com/CN/Y2014/V16/I7/430

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