Objective To evaluate the efficacy of bimanual microincisional cataract surgery (B-MICS) versus conventional coaxial small-incision cataract surgery (C-SICS) for visual quality. Methods A systematic review of B-MICS and C-SICS was conducted by a computer search on Medline, EMCC, OVID, and CNKI and a supplementary manual search was also done. The effect was measured as an odds ratio (OR) and weighted mean difference (WMD). Review manager 4.2 software was used to perform the meta-analysis. A sensitivity analysis was then performed and a publication bias was evaluated by a funnel plot and Egger's regression test. Results Only relevant articles from the resource material were included and/or excluded using a strict criterion. A total of 9 articles were included in the meta-analysis. The ORs of naked visual acuity 0.5 or better at 1 day, 1 week, and 1 month after surgery were 1.82 (95%CI was 1.38-2.39), 2.36 (95%CI was 1.27-4.37) and 1.61 (95% CI was 1.08-2.41), respectively. The differences were statistically significant (P<0.05). The OR of the best corrected visual acuity 0.5 or better at 1 month after surgery was 1.69 (95% CI was 0.93-3.07), but there was no statistically significant difference (P>0.05). A summary WMD of the meta-analysis showed a significant reduction in surgically induced astigmatism in the B-MICS group (WMD =-0.35 D, 95%CI:-0.48- -0.21 D, P<0.01). Sensitivity analysis and publication bias showed that the outcomes of this research were stable and reliable. Conclusion The evidence currently available showed that B-MICS is a safer and more reliable surgery for restoration of visual acuity and reducing surgically induced astigmatism in patients with cataract.%目的 系统评价双手微小切口(B-MICS)与传统同轴白内障超声乳化吸除术(C-SICS)对术后视觉质量的影响.方法 通过计算机文献检索,结合手工检索,对纳入的有关B-MICS和C-SICS临床疗效的相关文献进行Meta分析,以比值比(OR)和加权均数差值(WMD)为效应量,应用Review Manager 4.2软件进行Meta分析.对检索所得资料进行敏感性分析,并评价其发表偏倚.结果 共有9篇文献纳入研究.术后1 d、1周、1个月,裸眼视力≥0.5的合并OR值分别为1.82(95%CI:1.38～2.39)、2.36(95%CI:1.27～4.37)和1.61(95%CI:1.08～2.41).术后1个月.手术源性散光合并WMD值为-0.35 D(95%CI:-0.48～-0.21 D),差异有统计学意义(P<0.01).术后1个月,最佳矫正视力≥0.5的合并OR值为1.69(95%CI:0.93～3.07),差异无统计学意义.敏感性分析及发表性偏倚结果显示本研究结果具有较好稳定性.结论 B-MICS可减少手术源性散光,使患者术后视力恢复得更快、更好.
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