背景:无缝线巩膜固定人工晶状体植入术(SF-IOL)因其优点已成为临床治疗无晶状体眼的主流方案之一。如避免人工晶状体脱位或缝线降解或骨折引起的半脱位,术后视力显著提高。然而,关于这种手术和其他方法的相对有效性和安全性仍缺乏共识。本研究旨在比较无缝合SF-IOL与其他方法的疗效和安全性。无晶状体意味着镜头离开正常位置并失去其原始功能,包括可能导致屈光参差性弱视的晶状体缺失或完全脱位和半脱位,斜视,儿童和青少年双眼功能丧失。对于成年人来说,晶状体的丢失可能导致高度远视并影响视力。首先,这种疾病会严重影响患者的生活质量。
方法:关于PubMed中无缝合SF-IOL的文献,科克伦图书馆,Embase,WebofScience,中国国家知识基础设施,中国技术期刊VIP数据库,对2000年至2022年出版的万方数据库进行了综述。采用RevMan5.3软件计算加权平均差进行分析。两名研究人员独立选择了这项研究,并使用Cochrane协作工具来评估错误的风险。使用Cochrane偏倚风险工具评估证据质量。本研究在PROSPERO(CRD42022363282)上注册。
结果:无缝线SF-IOL术后IOL相关散光低于缝线SF-IOL,比较无缝线SF-IOL和缝线SF-IOL后的绝对球面当量,差异有统计学意义。表明无缝线SF-IOL后屈光不正程度较低。同时,无缝线SF-IOL的手术时间短于缝线SF-IOL的手术时间。亚组分析表明,Yamane技术的绝对术后等效球眼和散光值均低于缝合SF-IOL。
结论:无SutuelessSF-IOL具有屈光稳定的优点,操作时间短,术后并发症少。然而,缺乏高质量的文献来比较这些技术。需要一些长期随访的纵向前瞻性研究来证实这一发现。
BACKGROUND: Sutureless scleral fixed intraocular lens implantation (SF-IOL) has become one of the mainstream schemes in clinical treatment of aphakic eyes because of its advantages, such as avoiding dislocation of intraocular lens or subluxation caused by suture degradation or fracture and significant improvement of postoperative visual acuity. However, a consensus on the relative effectiveness and safety of this operation and other methods is still lacking. This study aimed to compare the efficacy and safety of
sutureless SF-IOL with other methods. Aphakia means that the lens leaves the normal position and loses its original function, including absence or complete dislocation and subluxation of the lens which could cause anisometropic amblyopia, strabismus, and loss of binocular function in children and adolescents. For adults, the loss of the lens could lead to high hyperopia and affect vision. Above all this disease can seriously affect the quality of life of patients.
METHODS: Literature about sutureless SF-IOL in PubMed, Cochrane Library, Embase, Web of Science,
China National Knowledge Infrastructure,
China Technical Journal VIP database, and Wanfang database published from 2000 to 2022 was reviewed. The weighted average difference was calculated by RevMan5.3 software for analysis. Two researchers independently selected the study and used the Cochrane collaboration tool to assess the risk of errors. Cochrane bias risk tool was used to evaluate the quality of evidence. This study is registered on PROSPERO (CRD42022363282).
RESULTS: The postoperative IOL-related astigmatism of sutureless SF-IOL was lower than that of suture SF-IOL, and there was statistical difference when we compared the absolute postoperative spherical equivalent after sutureless SF-IOL and suture SF-IOL. Indicating that the degree of refractive error after
sutureless SF-IOL was lower. Meanwhile, the operation time of
sutureless SF-IOL was shorter than that of suture SF-IOL. The subgroup analysis showed that the absolute postoperative spherical equivalent and astigmatism values in Yamane technique were lower than those in suture SF-IOL.
CONCLUSIONS: Sutureless SF-IOL has the advantages of stable refraction, short operation time, and less postoperative complications. However, high-quality literature to compare these technologies is lacking. Some long-term follow-up longitudinal prospective studies are needed to confirm the findings.