角膜塑形镜治疗亚洲儿童近视有效性和安全性的Meta分析

摘要

目的:系统评价角膜塑形镜治疗亚洲儿童近视的有效性和安全性.方法:检索The Cochrane Library、Medline、EMbase、CBM、CNKI、VIP和WanFang数据库,语种限定为中英文.采用Cochrane手册提供的偏倚风险评价工具和MINORS(methodological index for non-randomized studies)量表分别评价纳入文献(随机对照试验和对照试验)的质量;采用漏斗图检测纳入文献的发表偏倚;采用RevMan 5.3软件进行Meta分析.结果:共有7篇文献符合纳入排除标准,包含478例研究对象(角膜塑形镜组250例,对照组228例).Meta分析结果显示:角膜塑形镜对控制眼轴长度增加方面优于单光镜,两组之间的差异具有统计学意义[WMD=-0.31,95％CI(-0.35,-0.26),P<0.001].5篇文献观察了不良反应,均报道有中等程度角膜荧光素染色阳性的不良反应,一篇报道有1例患儿出现睑板腺囊肿,未见严重不良反应报道.结论:角膜塑形镜可有效控制亚洲儿童近视的发展,且较为安全.%AIM: To assess the efficacy and safety of orthokeratology for reducing the progression of myopia in Asia children.?METHODS: Seven databases, including the Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and WanFang Data, were searched. The published languages were limited to English and Chinese. The risk bias tool provided by Cochrance cooperation and methodological index for non-randomized studies ( MINORS) scale were used to assess the risk bias of included studies (randomized controlled trials and controlled trials). The published biases of included studies were assessed with funnel plot. Meta-analysis was performed with Review Manager 5. 3.? RESULTS: Seven eligible studies, including 478 children, were included, 250 cases in ortho-k group, 228 cases in control group. The Meta-analysis indicated that change in axial length of ortho-k group was significantly less than the control group [WMD=-0. 31, 95％CI(-0. 35,-0. 26), P<0. 001]. Five studies observed adverse effects which all included the effect of positive staining of corneal fluorescein. One study reported chalazion in one child. None of the studies reported severe adverse events.? CONCLUSION: The overall findings suggested that orthokeratology might slow the progression of myopia in children of Asia.