人工晶状体光学材料对后囊膜混浊影响的荟萃分析.doc

人工晶状体光学材料对后囊膜混浊影响的荟萃分析 人工晶状体光学材料对后囊膜混浊影响的 荟萃分析 ? 822?ShanghaiMedJ,2007,Vol30,No11 专题研究 人工晶状体光学材料对后囊膜混浊 影响的荟萃分析 程金伟魏锐利蔡季平马晓晔 【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)的合并危险差为一2O (95%CI为一24,一16),硅凝胶和PMMA的合并危险差为一8(95CI为一15,,1%oo),水凝胶和 PMMA的合并危险差为1O%(95CI为,9%,29),硅凝胶和疏水性丙 烯酸的合并危险差为4(95CI为 一 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 (95CI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. 【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 Effectofdifferentintraocularlensopticmaterialsonposteriorcapsularopacification:arecta-analysisCHENGJin— wei,WEIRuili,CAIJiping,MAXiaoye.DepartmentofOphthalmology,ChangzhengHospital,Second MilitaryMedicalUniversity,Shanghai200003,China C0rrPs0gauthor:WEIRuili,E-mail:ruiliwei@ [Abstract]ObjectiveTosystemicevaluatetheeffectofdifferentintraocularlensopticbiomaterialsonpos— teriorcapsuleopacification.MethodsAmeta—analysisofpublishedrandom izedclinicaltrialswasdesigned.Pub— lishedarticleswereselectedforstudybasedonacomputerizedsearchofthelite ratureandamanualsearchofthe bibliographiesofrelevantarticles.Therandomizedcontrolledtrialsmeetingselectedcriteriawerereviewedsyste- analysis.Datawereextractedonthebasisoftheintention maticallybymeta— —to-treatprinciple.Thecombinability ofthestudieswasassessedaccordingtOtheclinicalandstatisticalcriteria.Therapeuticeffectwasmeasuredasrisk difference,andpooledestimateswerecomputedaccordingtOarandomeffectmode1.ResultsAtotalof14trials wereincludedwithdifferentbiomaterials.Thepooledriskdifferenceswere一20[一24oA,,16]between acrylicandPMMA.一8[一15,一1]betweensiliconeandPMMA,4[一 1,8]betweensiliconeand acrylic,10[一 9,29]betweenhydrogelandPMMA,14[1,26]betweenhydrogelandacrylic,and 23[8,39]betweenhydrogelandsilicone.ConclusionIntraocularlensesmadefromacrylica