Toric IOL植入术与PCRI联合传统IOL植入术 矫正白内障患者角膜散光的Meta分析

doi:10.3760/cma.j.cn115909-20200727-00312

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Abstract Objective: To systematically evaluate by meta-analysis the effectiveness, safety and visual function of toric intraocular lens (IOL) implantation and traditional IOL implantation combined with peripheral corneal relaxing incisions (PCRI) in the correction of age-related cataract with ≤3 diopters (D) of corneal astigmatism. Methods: In this evidence-based medical research. PubMed, EMBASE, Cochrane library, Clinicalkey, Web of Science, CNKI, Wanfang, and VIP databases were searched for studies investigating the effect of the toric IOL in the treatment of cataract and corneal astigmatism. Meta-analysis was performed using RevMan 5.3 software to analyze the uncorrected distance visual acuity (UCDVA), residual astigmatism and astigmatism correction between the toric IOL and traditional IOL. Visual acuity was recorded in the form of the LogMAR visual acuity chart. Results: A total of 510 eyes of 352 cataract patients in 8 randomized, controlled trials were included. Meta-analysis results showed that: (1)the mean deviation (MD) of postoperative uncorrected distance visual acuity (logMAR UDVA) at 3 and 6 months was better in the toric intraocular lens group; (2)astigmatism correction at 3 and 6 months after implantation was better in the toric IOL group; (3)postoperative residual astigmatism at 1 month and; (4)at 3 and 6 months was lower for the toric intraocular lens; and (5)there was no significant difference in contrast sensitivity between the toric IOL group and the PCRI group at 3 months. The following data analyses support these findings: (1)MD=-0.04(95%CI: -0.07- -0.01, P=0.005); (2)MD=0.56(95%CI: 0.36- 0.76, P<0.001), standard mean deviation (SMD)=0.94(95%CI: 0.47-1.40, P<0.001); (3)at one month: MD= -0.13(95%CI: -0.21- -0.04, P=0.003), SMD=-0.34(95%CI: -0.59- -0.10, P=0.007); (4)at 3 and 6 months: MD=-0.30(95%CI: -0.51- -0.10, P=0.004), SMD=-0.84(95%CI: -1.42- -0.25, P=0.005); (5)MD=-0.01(95%CI: -0.08- 0.11, P=0.77). Conclusions: Toric IOL is superior to traditional IOL implantation combined with PCRI in correcting ≤3 D of corneal astigmatism in cataract patients. The toric IOL has a slight advantage in improving UCDVA, but the difference may not be clinically important. So far, there was no significant difference between the toric IOL and traditional IOL implantation combined with PCRI in postoperative visual function and vision-related quality of life.

Key words： cataract corneal astigmatism toric intraocular lens peripheral corneal relaxing incisions meta-analysis

Received: 27 July 2020

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Corresponding Authors: Jun Wang, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China (Email: prince909090@163.com)

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