肝素化人工晶状体预防后囊膜混浊的Meta分析

Effect of heparin-surface-modified intraocular lenses on posterior capsular opacification:meta-analysis of randomized clinical trial

目的系统评价肝素化（HSM）聚甲基丙烯酸甲酯（PMMA）人工晶状体（IOL）对白内障摘出术后后囊膜混浊（PCO）的预防作用。方法通过计算机检索Cochrane图书馆、Medline、Embase和中国生物医学文献数据库，获得以往发表的随机对照临床研究进行Meta分析。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12个随机对照临床试验纳人Meta分析。HSMPMMAIOLs与非肝素化PMMAIOLs相比，PCO发生率的合并危险差为0．04（95％CI：-0．04—0．11），激光囊膜切开术的合并危险差为-0．11（95％CI：-0．23—0．02）。结论与传统的非肝素化PMMAIOL相比，HSMPMMAIOL不能减少PCO的发生及激光囊膜切开术的使用。

Objective Binding heparin to the polymethylmethacrylate（PMMA） surface appears to decrease foreign-body- induced inflammation by making the intraocular lens（IOL） more hydrophilic, and therefore it may play a role in reducing posterior capsular opacification （PCO）. This study was to evaluate the efficacy of heparin-surface-modified （HSM） PMMA IOL in preventing PCO after cataract extraction. Methods Pertinent studies were selected through an electronic search of the Cochrane Library, Medline, Embase, and CBMdisc. The randomized controlled trials meeting the pre-defined criteria were systematically reviewed by meta-analysis. Outcome measures included the PCO rates and the use rates of Nd： YAG laser capsulotomy. The treatment effects were measured as risk difference and the pooled estimates were computed according to a random effect model. ResuIts A total of 12 randomized controlled trials were included in the present meta-analysis. The pooled risk difference of the PCO rates was 0. 04 （ -0.04 to 0. 11 ） in comparison to HSM PMMA IOLs with unmodified PMMA IOLs. The pooled risk difference of the use rates of Nd ：YAG laser capsulotomy was - 0. 11 （ - 0. 23 to 0. 02） in comparison to HSM PMMA IOLs with unmodified PMMA IOLs. ConcIusion The HSM PMMA IOL appears to be as effective as conventional unmodified PMMA IOL in preventing the formation of PCO and reducing the use of Nd ：YAG laser capsulotomy.