多焦点人工晶状体植入术后客观视觉质量评估的Meta分析

Meta-analysis of evaluation on objective visual quality after multifocal intraocular lens implantation

目的:系统评价多焦点人工晶状体植入术后客观视觉质量的情况。方法:检索PubMed、The Cochrane library、CNKI、Sinomed、迈特思创、万方数据库,检索时限均从建库至2019-12-31。对研究多焦点人工晶状体植入术后客观视觉质量的文献进行Meta分析,其中客观视觉质量的评价基于双通道客观视觉质量分析系统(OQASⅡ),包括以下指标:客观散射指数(OSI),调制传递函数截止频率(MTF cut off),斯特列尔比(SR),模拟100%对比度视力(OV100%)、模拟20%对比度视力(OV20%)、模拟9%对比度视力(OV9%)。结果:共有8篇文献纳入研究,共432例567眼。Meta分析结果显示:多焦点人工晶状体与单焦点对照组OSI比较差异有统计学意义[MD=0.66,95%CI(0.42~0.90),P<0.05],而MTF cut off[MD=-1.94,95%CI(-5.58~1.70),P=0.30],SR[MD=0.00,95%CI(-0.02~0.02),P=0.87],OV100%[MD=-0.02,95%CI(-0.14~0.11),P=0.76],OV20%[MD=-0.03,95%CI(-0.14~0.08),P=0.60],OV9%[MD=-0.01,95%CI(-0.09~0.07),P=0.82]差异均无统计学意义。结论:多焦点人工晶状体植入术后客观散射增加可能导致视觉质量下降,其余客观视觉质量参数与单焦点对照组无明显差异。纳入研究均未报道后期随访的情况,由于术后的变化及适应性,多焦点人工晶状体植入术后患者客观视觉质量的远期评估还需要进一步研究。

AIM:To review the objective visual quality after multifocal intraocular lens implantation.METHODS:The PubMed,The Cochrane Library,CNKI,Sinomed,Metstr,Wanfang Database were searched for Meta-analysis of the literature on the objective visual quality after multifocal intraocular lens implantation.The retrieval time limit is from the establishment of the database to December 31,2019.The objective visual quality was evaluated based on the objective visual quality analysis systemⅡ(OQASⅡ),which included object scatter index(OSI),modulation transfer function cut off(MTF cut off),Strehl ratio(SR),predicted 100%contrast visual acuity(OV100%),predicted 20%contrast visual acuity(OV20%),and predicted 9%contrast visual acuity(OV9%).RESULTS:A total of 8 articles met the inclusion criteria of this study,a total of 432 cases(567 eyes).Meta-analysis showed that there was significant difference between multifocal intraocular lens and monofocal control group in OSI[MD=0.66,95%CI(0.42-0.90),P<0.05],but there was no significant difference in MTF cut off[MD=-1.94,95%CI(-5.58-1.70),P=0.30],SR[MD=0.00,95%CI(-0.02-0.02),P=0.87],OV100%[MD=-0.02,95%CI(-0.14-0.11),P=0.76],OV20%[MD=-0.03,95%CI(-0.14-0.08),P=0.60],OV9%[MD=-0.01,95%CI(-0.09-0.07),P=0.82].CONCLUSION:The increase of objective scattering after multifocal intraocular lens implantation may lead to the decrease of visual quality,and the other parameters have no significant difference with the control group.However,no patient follow-up was reported in the included studies.Due to the changes and adaptability after operation,the long-term evaluation of objective visual quality of patients after multifocal intraocular lens implantation needs further research.