摘要
目的系统评价准分子激光原位角膜磨镶术(LASIK)与准分子激光角膜上皮瓣下磨镶术(LASEK)比较治疗近视的疗效与安全性。方法计算机检索PubMed、EMbase、Cochrane图书馆(2010年2期)、CNKI、VIP及万方数据库(1990.01～2010.10),检索语种限制为中、英文,纳入LASIK对比LASEK治疗近视的随机对照试验(RCT),按照Cochrane系统评价方法选择试验、提取有效数据和评价质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入7个RCT,包括1134只近视眼。Meta分析结果显示:LASIK和LASEK治疗近视在有效性[OR=1.23,95%CI(0.73,2.07)]、可预测性[OR=1.73,95%CI(0.74,2.53)]和安全性[OR=1.10,95%CI(0.22,5.59)]上差异均无统计学意义;与LASIK相比,LASEK术后眼部疼痛发生率较高[RR=0.13,95%CI(0.08,0.22)]。结论 LASIK和LASEK治疗近视疗效相同,但LASEK术后眼部疼痛发生率较高。但受纳入研究质量低、统计结果不稳定等因素的限制,上述结论尚需更多设计严谨的大样本RCT进一步验证。
ObjectivesTo assess the clinical effectiveness of laser in situ keratomileusis（LASIK） versus laser epithelial keratomileusis（LASEK） for the correction of myopia.Methods Randomised controlled trials（RCTs） were searched in PubMed,EMbase,The Cochrane Library（Issue 2,2010）,CNKI,VIP,and WangFang Data from January,1990 to October,2010.The RCTs were included in accordance with the Cochrane review＇s methodology,the valid data were extracted,the quality was evaluated,and then the RevMan 5.0 software was used for statistical analyses.Results Seven RCTs involving 1 134 eyes with myopia were included.The results of meta-analyses showed that the efficacy（OR=1.23,95%CI 0.73 to 2.07）,accuracy（OR=1.73,95%CI 0.74 to 2.53） and safety（OR=1.10,95%CI 0.22 to 5.59） outcomes between LASIK and LASEK were comparable.Compared with LASIK,LASEK was higher in the incidence rate of postoperative eye pain（RR=0.13,95%CI 0.08 to 0.22）.Conclusion LASIK and LASEK have the same effectiveness for myopia,but LASEK induces more postoperative eye pains.A large number of strictly-designed multi-centred RCTs are required for further verifying this result because of the low quality and instable results of the included studies.
出处
《中国循证医学杂志》
CSCD
2011年第5期565-569,共5页
Chinese Journal of Evidence-based Medicine
