背景:小切口透镜摘除(SMILE)在解决近视散光方面取得了显着进步。然而,回旋对手术结局的潜在影响不容忽视.本研究旨在评估在SMILE手术中应用回旋补偿技术矫正近视散光的有效性。检查其对术后视觉质量的影响。
方法:进行系统评价和荟萃分析。使用数据库进行了全面的文献检索,包括PubMed,WebofScience,EMBASE,科克伦图书馆,EBSCO,Scopus,CNKI,VIP,和万芳。选择并纳入符合标准的研究。数据由三位作者独立提取。使用ReviewManager版本5.3分析临床结果参数。
结果:本荟萃分析包括10项研究。结果表明,与对照组相比(在SMILE中未进行回旋补偿),回旋补偿组的以下指标是:残余散光(RA)[加权平均差(MD)=0.73,95%置信区间(CI)0.26至1.19,P=0.002],球形当量(SE)(MD=1.99,95%CI+0.77至+3.21,P=0.001),昏迷(MD=-0.06,95%CI-0.08至-0.04,P<0.00001),高阶像差(HOAs)(MD=-0.04,95%CI-0.06至-0.02,P<0.0001),随访6个月误差角(AE)(MD=-2.67,95%CI-3.71至-1.63,P<0.00001),随访6个月未矫正视力(UDVA)(MD=-0.05,95%CI-0.08至-0.01,P=0.005),结果差异有统计学意义。然而,校正指数之间的差异,成功指数(IOS)目标诱导散光(TIA),误差幅度(ME),球差(SA)无统计学意义。
结论:周期旋转补偿被证明对矫正近视散光是有效和可预测的。回旋补偿组在术后残余散光方面优于对照组,它引起的昏迷畸变较少。回旋补偿是否可以带来更好的视觉质量还有待观察,通过旋转补偿矫正近视散光的进一步研究是必要的。
BACKGROUND: Small incision lenticule extraction (SMILE) has made notable advancements in addressing myopic
astigmatism. Nevertheless, the potential impact of cyclotorsion on surgical outcomes cannot be overlooked. This study aims to assess the effectiveness of cyclotorsion compensation technology in SMILE surgery for the correction of myopic
astigmatism, examining its influence on postoperative visual quality.
METHODS: A systematic
review and meta-analysis were conducted. A comprehensive literature search was performed using databases, including PubMed, Web of Science, EMBASE, Cochrane Library, EBSCO, Scopus, CNKI, VIP, and Wan Fang. Studies meeting the criteria were selected and included. Data were independently extracted by three authors. Clinical outcome parameters were analyzed using
Review Manager version 5.3.
RESULTS: This meta-analysis included ten studies. The results showed that, compared with the control group (cyclotorsion compensation was not performed in SMILE), the following indicators in the cyclotorsion compensation group were: residual astigmatism (RA) [weighted mean difference (MD) = 0.73, 95% confidence interval (CI) + 0.26 to + 1.19, P = 0.002], spherical equivalent (SE) (MD = 1.99, 95% CI + 0.77 to + 3.21, P = 0.001), coma (MD = -0.06, 95% CI -0.08 to -0.04, P < 0.00001), higher-order aberrations (HOAs) (MD = -0.04, 95% CI -0.06 to -0.02, P < 0.0001), follow-up 6-month angle of error (AE) (MD = -2.67, 95% CI -3.71 to -1.63, P < 0.00001), and follow-up 6-month uncorrected distance visual acuity (UDVA) (MD = -0.05, 95% CI -0.08 to -0.01, P = 0.005), and the differences in results were statistically significant. However, the differences among correction index, index of success (IOS), targeted induced
astigmatism (TIA), magnitude of error (ME), and spherical aberration (SA) were not statistically significant.
CONCLUSIONS: Cyclotorsion compensation proves to be effective and predictable for correcting myopic astigmatism. The cyclotorsion compensation group demonstrated advantages over the control group in terms of postoperative residual astigmatism, and it induced fewer coma aberrations. Whether cyclotorsion compensation can lead to better visual quality remains to be seen, and further research on correcting myopic astigmatism through cyclotorsion compensation is warranted.