角膜塑形镜对高度近视患者矫正效果的Meta分析

摘要

目的：：系统评价高度近视患者配戴角膜塑形镜1 wk~1 a后视力及屈光度的变化。方法：计算机检索 PubMed、EMbase、CBM、CNKI、VIP 和WanFang Data,并辅以手工检索、因特网搜索的相关文献,检索时限均从建库至2015-09,文种限中、英文。资料提取和纳入研究的方法学质量评价后,采用RevMan5.3软件进行Meta分析。结果：最终纳入6篇文献,共909眼。 Meta分析结果显示：与配戴角膜塑形镜前比较,配戴角膜塑形镜1wk,1、3、6mo,1a后,视力得到一定程度改善[1wk：MD=-0.34,95%CI(-0.55,-0.14),P=0.001；1mo：MD=-0.50,95%CI(-0.69,-0.30),P<0.01；3mo：MD=-0.54,95%CI(-0.70,-0.37),P<0.01；6mo：MD=-0.49,95%CI(-0.50,-0.47),P<0.01；1a：MD=-0.46,95%CI(-0.64,-0.29),P<0.01]。屈光度也得到有效的控制[1a：MD=1.10,95%CI(-0.73,2.93),P=0.24]。结论：角膜塑形镜是矫正高度近视和控制高度近视发展的有效方法之一,但长期疗效仍需进一步随访证实。%AlM: To systematically evaluate the change of vision and diopter in 1wk to 1a in the patients with high myopia receiving orthokeratology treatment. METHODS: Such databases as PubMed, EMbase, CBM, CNKl, VlP, and WanFang Data were searched. The retrieval time was from inception to September 2015, and the language was in both Chinese and English. After extracted the data and assessed the quality of the included studies, the Meta - analysis was performed by using RevMan 5. 3 software.RESULTS: A total of 6 studies involving 909 eyes were included. The results of Meta - analysis showed that, compared with that before wearing orthokeratology, the visual acuity improved in orthokeratology group at 1wk, 1, 3, 6mo and 1a [1wk: MD=-0. 34, 95%CI(-0. 55,-0. 14), P=0. 001;1mo: MD=-0. 50, 95%CI(-0. 69,-0. 30), P<0. 01; 3mo: MD=-0. 54, 95%CI(-0. 70,-0.37), P<0.01;6mo:MD=-0.49,95%CI(-0.50,-0.47), P<0. 01;1a:MD=-0. 46, 95%CI(-0. 64, -0. 29), P<0. 01]. After wearing orthokeratology 1a, diopter also be effectively controlled [MD=1. 10, 95%CI(-0. 73, 2. 93), P=0. 24].CONCLUSlON: Orthokeratology is an effective control method to correct high myopia and high myopia development. But further studies are still required for its long-term effect.