角膜塑形镜与框架镜控制近视进展的Meta分析

Orthokeratology versus single-vision spectacles for myopic control:a meta-analysis

目的评价角膜塑形镜控制儿童近视进展的有效性及安全性。方法计算机检索Pubmed、OVID、The Cocharane Library、EMbase、CBM、万方、CNKI等数据库，全面收集角膜塑形镜控制儿童近视的随机对照试验（RCT）及非随机的前瞻性同期对照临床试验，检索时间为1990年1月至2014年5月，并追溯纳入文献的参考文献。由2位研究者按照纳入与排除标准独立筛选文献、提取资料及评价文献质量，采用RevMan5．2软件进行Meta分析。结果共纳入5篇文献，323例患者。Meta分析结果显示，角膜塑形镜在控制眼轴增长方面明显优于框架镜，两组差异有统计学意义[MD=-0．25，95％CI（-0，32，-0．19），P〈0．00001]。角膜塑形镜组玻璃体腔深度延长少于框架镜组（P〈0001）。角膜塑形镜组出现6例角膜荧光索染色阳性，1例角膜浸润，1例结膜充血．结论角膜塑形镜能明显控制低度近视儿童的眼轴增长，角膜荧光染色阳性是主要并发症。

Objective To evaluate the effectiveness and safety of orthokeratology （ortho-k） for myopia progress con- trol in children. Methods Literature search was conducted from Pubmed, OVID, Cocharane Library, EMbase, CBM, WangFang Data and CNKI for articles published between January 1990 and May 2014. All these articles adopted randomized controlled tri- als or non-randomized prospective trials with comparable baseline between groups. Two reviewers independently screened literature, extracted data, and assessed the quality of methodology of included studies. The meta-analysis was performed using RevMan 5.2 software. Results The meta-analysis included 323 subjects from 5 studies. Results indicated that the axial elongation was significantly slower in ortho-k group （MD= -0.25, 95%CI：-0.32, -0.19, P〈0.00001）. The extension of vitreous chamber depth （VCD） was less in ortho-k than that in single vision spectacles group （P〈0.001）. The adverse events in ortho-k treatment group included corneal fluorescein staining in 6 cases, corneal infiltration in 1 case and conjunctival hyperemia in 1 case. Conclusion Ortho-k lenses can slower the axial elongation in low myopia children, and corneal staining is the main complication for ortho-k.