Wen, D;
Tu, R;
Flitcroft, I;
Wang, Q;
Huang, Y;
Song, B;
Yu, A;
... Huang, J; + view all
(2018)
Corneal Surface Ablation Laser Refractive Surgery for the Correction of Myopia: A Network Meta-analysis.
Journal of Refractive Surgery
, 34
(11)
pp. 726-735.
10.3928/1081597X-20180905-01.
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Abstract
PURPOSE: To systematically compare the efficacy, predictability, safety, postoperative haze, pain scores, and epithelial healing time of four corneal surface ablation procedures. METHODS: PubMed, Embase, Cochrane Library, and the U.S. trial registry were searched up to June 2018. Randomized controlled trials were selected. Efficacy (uncorrected distance visual acuity of 20/20 or better), predictability (refractive spherical equivalent within ±0.50 diopters [D] of the target), and safety (loss of two or more lines of spectacle corrected distance visual acuity) were set as primary outcome measures. Haze, pain scores, and epithelial healing time were set as secondary outcome measures. RESULTS: Eighteen studies involving 1,423 eyes were included. According to the Grading of Recommendations Assessment, Development, and Evaluation, the quality of outcomes were moderate to high (70.6%). There were no differences in efficacy, predictability, safety, haze, day 1 pain, and epithelial healing time between treatments. Epithelial laser in situ keratomileusis (epi-LASIK) had statistically significantly higher pain scores on day 3 compared to photorefractive keratectomy (PRK) (weighted mean differences [WMD] = 2.2, 95% credible intervals [CrI] = 0.19 to 4.01) and transepithelial PRK (T-PRK) (WMD = 2.7, 95% CrI = 0.51 to 4.84). The surface under the cumulative ranking curve ranking results (best to worst) showed laser epithelial keratomileusis (LASEK) ranked highest for efficacy, predictability, safety, and day 1 pain scores. Epi-LASIK ranked best for grade 1 haze scores. T-PRK ranked best for haze of 0.5 or higher, haze scores day 3 pain scores, and epithelial healing time. CONCLUSIONS: Surface laser refractive surgeries are comparable in terms of efficacy, predictability, safety, and postoperative haze except for day 3 pain scores, with epi-LASIK being more painful compared to PRK and T-PRK. [J Refract Surg. 2018;34(11):726-735.].
| Type: | Article |
|---|---|
| Title: | Corneal Surface Ablation Laser Refractive Surgery for the Correction of Myopia: A Network Meta-analysis |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3928/1081597X-20180905-01 |
| Publisher version: | https://doi.org/10.3928/1081597X-20180905-01 |
| Language: | English |
| Additional information: | This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (https://creativecommons.org/ licenses/by-nc/4.0). This license allows users to copy and distribute, to remix, transform, and build upon the article non-commercially, provided the author is attributed and the new work is non-commercial. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10063388 |
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