目的:进行这项研究是为了确定具有较小的后视区直径(BOZD)的角膜矫正术(OK)镜片是否可以表现出较强的近视控制效果。
方法:一项荟萃分析在PROSPERO(CRD42023408184)中注册。进行了全面系统的数据库检索,包括PubMed,科克伦图书馆,EMBASE,MEDLINE,WebofScience,奥维德,CNKI与CBM,确定截至2023年3月25日的相关研究。这项荟萃分析的主要纳入标准是研究光学治疗面积小(≤5mm)的OK镜片的近视控制效果。为了评估检索到的文章的质量,两名研究人员使用Cochrane偏倚风险评估标准进行评估.主要结局指标是眼轴长度(AL)和屈光不正的变化,使用加权平均差(WMD)和95%置信区间(CI)评估小型光学治疗区组和传统光学治疗区组之间在这些结局方面的差异.
结果:分析包括五项符合条件的研究,为期1年。组间AL的平均差异为0.12mm(WMD=-0.12,95%CI[-0.16,-0.09],p<0.00001)。同样,两组间屈光不正的平均差异为0.44D(WMD=0.44,95%CI[0.30,0.57],p<0.00001)。没有一项研究报告严重的不良事件。
结论:目前的证据表明,具有较小光学治疗区的OK镜片在预防近视进展方面比传统镜片更有效。然而,有必要进行长期评估。
OBJECTIVE: This study was conducted to determine whether orthokeratology (OK) lenses with a smaller back optic zone diameter (BOZD) could exhibit stronger myopia control effects.
METHODS: A meta-analysis was registered in PROSPERO (CRD42023408184). A comprehensive systematic database search was conducted, encompassing PubMed, Cochrane Library, EMBASE, MEDLINE, Web of Science, Ovid, CNKI and CBM, to identify relevant studies up to 25 March 2023. The primary inclusion criteria for this meta-analysis were studies that investigated the myopia control effect of OK lenses with a small optical treatment area (≤5 mm). To assess the quality of the retrieved articles, two researchers evaluated them using the Cochrane bias risk assessment criteria. The primary outcome measures were the changes in axial length (AL) and refractive error, using the weighted mean differences (WMD) and 95% confidence intervals (CI) to assess differences between small and traditional back optical treatment zone groups in terms of these outcomes.
RESULTS: The analysis encompassed five eligible studies, with a 1 year duration. The average difference in AL between the groups was 0.12 mm (WMD = -0.12, 95% CI [-0.16, -0.09], p < 0.00001). Likewise, the average difference in refractive error between the two groups was 0.44 D (WMD = 0.44, 95% CI [0.30, 0.57], p < 0.00001). None of the studies reported severe adverse events.
CONCLUSIONS: Current evidence suggests that OK lenses with smaller back optical treatment zone are more effective in preventing myopia progression than traditional lenses. However, a longer-term evaluation is warranted.