两种人工晶状体植入术后发生后囊膜混浊情况的 Meta分析

摘要

目的：：系统评价AcrySof直角方边人工晶状体和Sensar前圆后方人工晶状体对术眼后囊膜混浊的预防作用。方法：计算机检索PubMed (1980/2015-09)、CBM (1990/2015-09)、VIP (1989/2015-09)、CNKI (1990/2015-09)和wanfang Data(1990/2015-09),收集年龄相关性白内障超声乳化联合植入 AcrySof 三片式人工晶状体与植入Sensar三片式人工晶状体术后后囊膜混浊发生情况的随机对照试验,由两名评价者按照纳入与排除标准筛选研究、提取资料和质量评价后,采用RevMan 5.2软件进行Meta分析。结果：共纳入5项研究,总计1036眼( AcrySof组553眼, Sensar组483眼),随访时限6mo~2a,Meta分析结果显示：(1) AcrySof 组术后 PCO 发生率显著低于 Sensar 组(OR=0.67,95%CI：0.45~0.99,P=0.04)；(2)两种人工晶状体植入后术眼后囊膜Nd：YAG激光切开术施行率比较,无统计学差异(OR=0.57,95%CI：0.32~1.02,P=0.06)。(3)2 a 以上长期随访亚组分析中, AcrySof 组PCO发生率显著低于Sensar组( OR=0.60,95%CI：0.40~0.91,P=0.02),两组人工晶状体术后后囊膜激光切开术施行率比较,无统计学差异( OR=0.60,95%CI：0.33~1.09,P=0.09)。结论：AcrySof三片式人工晶状体相比于Sensar三片式人工晶状体显示出较强的预防后囊膜混浊作用。%AlM: To compare posterior capsule opacification ( PCO ) after phacoemulsification cataract surgery with implantation of two different hydrophobic acrylic intraocular lenses ( lOLs) .METHODS: Such databases as PubMed ( 1980-Sep 2015),CBM(1990-Sep 2015),VlP(1989-Sep 2015),CNKl (1990-Sep 2015 ) and WanFang Data ( 1990-Sep 2015 ) were searched to collect the randomized controlled trials ( RCTs) about AcrySof 3-piece lOL vs Sensar 3-piece lOL for PCO or incidence of Nd:YAG laser capsulotomy. According to the inclusion and exclusion criteria, two reviewers independently screened the literatures, extracted data and assessed the quality of the included studies, then Meta - analysis was conducted using RevMan 5. 2 software.RESULTS: A total of 5 RCTs involving 1 036 eyes ( AcrySof group:553 eyes, Sensar group:483 eyes) were included, with a follow-up duration of 6mo ~ 2a. The results of Meta-analysis showed that:( 1 ) the incidence of PCO was significantly lower in AcrySof group than that in Sensar group(OR=0. 67,95%CI:0. 45~0. 99,P=0. 04);(2 ) the incidence of Nd:YAG laser capsulotomy after surgeries was similar between AcrySof group and Sensar group(OR=0. 57,95%CI:0. 32 ~1. 02,P=0. 06);(3) in an above 2a long - term follow - up subgroup analysis, AcrySof group indicated a significantly lower incidence of PCO(OR=0. 60,95%CI:0. 40 ~0. 91,P=0. 02), while the Nd: YAG laser capsulotomy incidence was similar between the two groups( OR=0. 60,95%CI:0. 33 ~1. 09,P=0. 09).CONCLUSlON: AcrySof 3-piece lOL seems to have a stronger preventive effect on PCO than Sensar 3-piece lOL. For the quantity limitation of the included studies, this conclusion still needs to be further proved by more high-quality RCTs.