飞秒激光制瓣的LASIK与SMILE术后角膜敏感性变化的Meta分析

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.%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.