Postoperative Efficacy, Predictability, Safety, and Visual Quality of Laser Corneal Refractive Surgery: A Network Meta-analysis.

摘要: Purpose To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms laser corneal refractive surgeries for correcting myopia. Design Systematic review network meta-analysis. Methods Search MEDLINE, EMBASE, Cochrane Library, US trial registry was conducted up to November 2015. Randomized controlled trials (RCT) reporting in accordance with eligibility criteria were included this review. We performed a Bayesian random-effects Results Forty-eight RCTs identified. For efficacy (uncorrected acuity [UCVA]), there no statistically significant differences between any pair treatments analyzed. The SUCRA (surface under cumulative ranking curve) (from best worst) femtosecond-based in situ keratomileusis (FS-LASIK), LASIK, small-incision lenticule extraction, femtosecond extraction (FLEx), photorefractive keratectomy (PRK), epithelial (LASEK), epipolis (Epi)-LASIK, transepithelial PRK (T-PRK). predictability (refractive spherical equivalent [SE]), difference found when FS-LASIK compared LASIK (odds ratio [OR] 2.29, 95% credible interval [CrI] 1.20–4.14), (OR 2.16, CrI 1.15–4.03), LASEK 2.09, 1.08–4.55), Epi-LASIK 2.74, 1.11–6.20). FS-LASIK, T-PRK, LASEK, PRK, Epi-LASIK. There safety (best spectacle-corrected acuity) comparisons. both higher-order aberrations (HOAs) contrast sensitivity (CS), results show that some surface ablation techniques (PRK LASEK) rank highest. Conclusions This meta-analysis shows either outcomes (efficacy safety) or (HOAs CS). behaved better than other type surgeries.