摘要
目的系统评价不同光学材料人工晶状体对后囊膜混浊的影响。方法通过计算机和手工检索,获得以往发表的相关文献。按照选择标准选取合适的随机对照临床研究进行荟萃(Meta)分析。按照意向性分析原则对纳入文献的相关资料进行提取摘录,并根据Meta分析的统计学方法进行合并分析。以钕:铱铝石榴石(Nd:YAG)激光囊膜切开术为临床治疗终点,以危险差来判定预防效果,选择随机效应模型计算总的治疗效应。结果总计有14个试验纳入Meta分析。疏水性丙烯酸和聚甲基丙烯酸甲酯(PMMA)的合并危险差为-20%(95%CI为-24%～-16%),硅凝胶和PMMA的合并危险差为-8%(95%CI为-15%～-1%),水凝胶和PMMA的合并危险差为10%(05%CI为-9%～29%),硅凝胶和疏水性丙烯酸的合并危险差为4%(95%CI为-1%～8%),水凝胶和疏水性丙烯酸的合并危险差为14%(1%～26%),水凝胶和硅凝胶的合并危险差为23%(95%CI为8%～39%)。结论硅凝胶和疏水性丙烯酸人工晶状体可以预防后囊膜混浊的发生,从而减少Nd:YAG激光囊膜切开术的应用,相反水凝胶人工晶状体不能减少囊膜切开术的应用。
Objective To systemic evaluate the effect of different intraocular lens optic biomaterials on posterior capsule opacification. Methods A meta-analysis of published randomized clinical trials was designed. Published articles were selected for study based on a computerized search of the literature and a manual search of the bibliographies of relevant articles. The randomized controlled trials meeting selected criteria were reviewed systematically by meta-analysis. Data were extracted on the basis of the intention-to-treat principle. The combinability of the studies was assessed according to the clinical and statistical criteria. Therapeutic effect was measured as risk difference, and pooled estimates were computed according to a random effect model. Results A total of 14 trials were included with different biomaterials. The pooled risk differences were -20%[-24%, -16%] between acrylic and PMMA. - 8% [- 15%, - 1%] between silicone and PMMA, 4 % [ - 1%, 8 %] between silicone and acrylic, 10%[-9%, 29%] between hydrogel and PMMA, 14%[1%, 26%] between hydrogel and acrylic, and 23%[8%, 39%] between hydrogel and silicone. Conclusion Intraocular lenses made from acrylic and silicone are associated with a significantly lower YAG rate. However, hydrogel intraocular lens is associated with inefficacy for avoiding capsulotomy. （Shanghai Med J, 2007, 30：822-827）
出处
《上海医学》
CAS
CSCD
北大核心
2007年第11期822-827,共6页
Shanghai Medical Journal
关键词
人工晶状体
后囊膜混浊
丙烯酸
硅凝胶
水凝胶
聚甲基丙烯酸甲酯
荟萃分析
Intraocular lens
Posterior capsular opacification
Acrylic
Silicone
Hydrogel
Polymethyl methacrylate
Meta-analysis
