非超声小切口白内障吸除术与囊外白内障摘除术对患者视力影响的Meta分析

Effect of Non-phacomulsification Versus Extracapsular Extraction on Visual Acuity:A Meta-analysis

目的：系统评价非超声小切口白内障吸除术与囊外白内障摘除术（ECCE）对患者视力的影响。方法：检索中国生物医学文献数据库对24篇有关非超声小切口白内障吸除术（小切口组）与ECCE（大切口组）的临床疗效进行Me-ta分析,以危险差判定2组的治疗效果,并按照随机效应模型计算合并危险差。结果：24篇文献共计白内障患者5 341例。术后近期（〈1周）和远期（1～3个月）小切口组和大切口组视力≥0.5的患者合并危险差分别为27%和17%（95%可信区间分别为17%～37%、7%～26%,P〈0.01）。术后角膜散光〉1D的合并危险差为36%（95%可信区间为19%～53%,P〈0.01）。结论：非超声小切口白内障吸除术后患者视力恢复快,且稳定,术后角膜散光小,是一种更适合我国国情的白内障扶贫复明手术,应大力在基层医院推广。

Objective： To analyze the efficacy of non-phacomulsification （non phaco） versus extracapsular extraction （ECCE） on visual acuity. Methods：Twenty-four cases related with non-phac and ECCE were retrieved from Chinese biomedical data base. The combinability of the studies was assessed in terms of clinical and statistical criteria. The curative effect was measured as risk difference between non-phac and ECCE. Pooled estimate was analyzed with a computer according to a random-effects model. Results： A total of 5341 patients were included in 24 trials. The pooled risk differences of visual acuity 0. 5 or better one week or 1-3 months after surgery were 27% （95% CI was 17%-27%）, 17 （95% CI was 7%-26%） respectively in non-phaco and ECCE. The pooled risk difference of corneal astigmatism 〉1D was 36% （95% CI was 19%-53%）. Conclusion： Non phaco is a safe and reliable surgery for restoration of visual acuity in patients with cataract. Corneal astigmatism after non-phaco is less than ECCE. Non-phaco is more suitable for helping the poor in China.