球面人工晶狀體與非球面人工晶狀體臨床應用效果的Meta分析_《中國循證醫學雜志》

作者：

 劉彥斌 ¹ , 譚少健 ² , 陳迎迎 ²

1. 江蘇省南京愛爾眼科醫院（南京 210006）；2．廣西醫科大學第一附屬醫院眼科（南寧 530021）;

關鍵詞：

白內障非球面人工晶狀體球面人工晶狀體系統評價

DOI：

10.7507/1672-2531.20090177

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價球面人工晶狀體（IOL）與非球面IOL 的臨床應用效果。
方法　采用Cochrane 系統評價方法，計算機檢索 CENTRAL（Cochrane 圖書館2008 第3 期）、MEDLINE（2000 ～ 2008 年10 月）、EMbase（2000 ～ 2008 年10 月），納入球面IOL 與非球面IOL 對照的超聲乳化白內障吸出聯合IOL 植入的隨機對照試驗。由兩名評價員分別提取資料，評價方法學質量后，采用RevMan 5.0 軟件進行Meta 分析。
結果　共納入14 個隨機對照試驗(1 383 只眼) 。按非球面IOL 的球差不同分三個亞組進行Meta 分析。結果顯示：① 術后最好矯正視力：AcrySof IQ IOL 亞組兩組間差異有統計學意義［WMD= –0.02，95%CI（–0.03，–0.01），P lt;0.000 1］；Tecnis Z9000 IOL亞組兩組間差異有統計學意義［WMD=0.02，95%CI（0.01，0.03），P=0.002］；非球面Tecnis IOL 與非球面AkreosAO IOL 亞組兩組間差異無統計學意義［WMD=0.00，95%CI ( –0.02，0.03)，P=0.71］。② 術后球面像差：AcrySof IQIOL 亞組兩組間差異有統計學意義［WMD= –0.06，95% CI（–0.08，–0.05），P lt;0.000 01］；Tecnis Z9000 IOL 亞組兩組間差異有統計學意義［WMD= –0.06，95%CI（–0.08，–0.05），P lt;0.000 01］；非球面Tecnis IOL 與非球面AkreosAO IOL亞組兩組間差異有統計學意義［WMD= –0.07，95%CI（ –0.11，–0.03），P=0.000 2］。③ 術后高階像差：非球面IOL 與球面IOL 植入術后高階像差差異有統計學意義［WMD = –0.05，95%CI（–0.07，–0.02）］。④ 術后對比敏感度：非球面IOL 能改善術后對比敏感度，尤其在暗視條件下更為明顯，但也有研究認為二者無顯著性差異。⑤術后視覺質量及不良視覺反應：非球面IOL 術后視覺效果更好，但兩組差異無統計學意義。
結論　現有有限證據表明，非球面IOL 比球面IOL 有較好的臨床應用效果。但對比敏感度等結論仍不一致。擴大樣本量，延長隨訪時間，觀察對比敏感度的變化是必要的。對不同球差的非球面IOL 臨床效果研究較少，應開展大樣本的隨機對照試驗，觀察其臨床效果。

引用本文： 劉彥斌,譚少健,陳迎迎. 球面人工晶狀體與非球面人工晶狀體臨床應用效果的Meta分析. 中國循證醫學雜志, 2009, 09(9): 1001-1009. doi: 10.7507/1672-2531.20090177 復制

1.	Resnikoff S, Pascolini D, Etya’ale D, et al. Global data on visual impairment in the year 2002. Bull WHO, 2004, 82: 844-851.
2.	Mester U, Dillinger P, Anterist N. Impact of a modified optic design on visual function: clinical comparative study. [Clinical Trial, Journal Article, Randomized Controlled Trial]. J Cataract Refract Surg, 2003, 29(4): 652-660.
3.	Kohen T. Aberratioon-correcting intraocular lenses. J Cataract Refract Surg, 2003, 29: 627-628.
4.	Guirao A, Tejedor J, Artal P. Corneal aberrations before and after small-incision cataract surgery. Invest Ophthalmol Vis Sci, 2004, 45(12): 4312-4319.
5.	Artal P, Guirao A, Berrio E, et al. Compensation of corneal aberrations by the internal optics in the human eye. J Vis, 2001, 1(1): 1-8.
6.	Taketani F, Yukawa E, Yoshii T, et al. Influence of intraocular lens optical design on high-order aberrations. J Cataract Refract Surg, 2005, 31(5): 969-972.
7.	Kershner RM. Retinal image contrast and functional visual performance with aspheric, silicone, and acrylic intraocular lenses. Prospective evaluation. J Cataract Refract Surg, 2003, 29(9): 1684-1694.
8.	Packer M, Fine IH, Hoffman RS. Aspheric intraocular lens selection: the evolution of refractive cataract surgery. Curr Opin Ophthalmol, 2008, 19(1): 1-4.
9.	Rocha KM, Soriano ES, Chamon W, et al. Spherical Aberration and Depth of Focus in Eyes Implanted with Aspheric and Spherical Intraocular Lenses A Prospective Randomized Study. Ophthalmology, 2007, 114: 2050-2054.
10.	Mu?oz G, Albarrán-Diego C, Montés-Micó R, et al. Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens. J Cataract Refract Surg, 2006, 32(8): 1320-1327.
11.	Kasper T, Bühren J, Kohnen T. Visual performance of aspherical and spherical intraocular lenses: Intraindividual comparison of visual acuity, contrast sensitivity, and higher-order aberrations. J Cataract Refract Surg, 2006, 32(12): 2022-2029.
12.	Denoyer A, Le Lez ML, Majzoub S, et al. Quality of vision after cataract surgery after Tecnis Z9000 intraocular lens implantation Effect of contrast sensitivity and wavefront aberration improvements on the quality of daily vision. J Cataract Refract Surg, 2007, 33(2): 210-216.
13.	Johansson B, Sundelin S, Wikberg-Matsson A, et al. Visual and optical performance of the Akreos Adapt Advanced Optics and Tecnis Z9000 intraocular lenses Swedish multicenter study. J Cataract Refract Surg, 2007, 33(9): 1565-1572.
14.	Higgins JPT, Sally Green, editors. Cochrane Reviewers’ Handbook Version 5.0.0. http://www.cochrane.org/resources/handbook/hbook. htm.
15.	Higgins JPT, Altman DG (editors): Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. The Cochrane Collaboration, 2008. Available from www.cochranehandbook. org.
16.	吳泰相, 劉關鍵. 隱蔽分鰈 (分配隱藏) 和盲法的概念、實施與報告. 中國循證醫學雜志, 2007, 7(3): 203-207.
17.	The Moorfields IOL Study Group. Binocular implantation of the Tecnis Z9000 or AcrySof MA60AC intraocular lens in routine cataract surgery Prospective randomized controlled trial comparing VF-14 scores. J Cataract Refract Surg, 2007, 33: 1559-1564.
18.	Bellucci R, Morselli S, Pucci V. Spherical aberration and coma with an aspherical and a spherical intraocular lens in normal age-matched eyes. J Cataract Refract Surg, 2007, 33(2): 203-209.
19.	Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J Cataract Refract Surg, 2007, 33(3): 497-509.
20.	Beiko GH. Personalized correction of spherical aberration in cataract surgery. J Cataract Refract Surg, 2007, 33(8): 1455-1460.
21.	Awwad ST, Warmerdam D, Bowman RW, et al. Contrast sensitivity and higher order aberrations in eyes implanted with AcrySof IQ SN60WF and AcrySof SN60AT intraocular lenses. J Refract Surg, 2008, 24(6): 619-625.
22.	Tzelikis PF, Akaishi L, Trindade FC, et al. Ocular aberrations and contrast sensitivity after cataract surgery with AcrySof IQ intraocular lens implantation Clinical comparative study. J Cataract Refract Surg, 2007, 33(11): 1918-1924.
23.	Casprini F, Balestrazzi A, Tosi GM, et al. Glare disability and spherical aberration with five foldable intraocular lenses: a prospective randomized study. Acta Ophthalmol Scand, 2005, 83(1): 20-25.
24.	Tzelikis PF, Akaishi L, Trindade FC, et al. Spherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study. Am J Ophthalmol, 2008, 145(5): 827-833.
25.	Caporossi A, Martone G, Casprini F, et al. Prospective randomized study of clinical performance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes. J Refract Surg, 2007, 23(7): 639-648.
26.	Bellucci R, Scialdone A, Buratto L, et al. Visual acuity and contrast sensitivity comparison between Tecnis and AcrySof SA60AT intraocular lenses: A multicenter randomized study. J Cataract Refract Surg, 2005, 31(4): 712-717.
27.	Lin IC, Wang IJ, Lei MS, et al. Improvements in vision-related quality of life with AcrySof IQ SN60WF aspherical intraocular lenses. J Cataract Refract Surg, 2008, 34(8): 1312-1317.
28.	Pandita D, Raj SM, Vasavada VA, et al. Contrast sensitivity and glare disability after implantation of AcrySof IQ Natural aspherical intraocular lens Prospective randomized masked clinical trial. J Cataract Refract Surg, 2007, 33(4): 603-610.
29.	Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg, 2002, 18(6): 683-691.
30.	Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J Cataract Refract Surg, 2007, 33(3): 497-509.
31.	Milauskas AT. Posterior capsule opacification after silicone lens implantation and its management. J Cataract Refract Surg, 1987, 13(6): 644-648.
32.	Findl O, Buehl W, Bauer P, et al. Interventions for preventing posterior capsule opacification. Cochrane Database Syst Rev, 2007, (3): CD003738.

1. Resnikoff S, Pascolini D, Etya’ale D, et al. Global data on visual impairment in the year 2002. Bull WHO, 2004, 82: 844-851.
2. Mester U, Dillinger P, Anterist N. Impact of a modified optic design on visual function: clinical comparative study. [Clinical Trial, Journal Article, Randomized Controlled Trial]. J Cataract Refract Surg, 2003, 29(4): 652-660.
3. Kohen T. Aberratioon-correcting intraocular lenses. J Cataract Refract Surg, 2003, 29: 627-628.
4. Guirao A, Tejedor J, Artal P. Corneal aberrations before and after small-incision cataract surgery. Invest Ophthalmol Vis Sci, 2004, 45(12): 4312-4319.
5. Artal P, Guirao A, Berrio E, et al. Compensation of corneal aberrations by the internal optics in the human eye. J Vis, 2001, 1(1): 1-8.
6. Taketani F, Yukawa E, Yoshii T, et al. Influence of intraocular lens optical design on high-order aberrations. J Cataract Refract Surg, 2005, 31(5): 969-972.
7. Kershner RM. Retinal image contrast and functional visual performance with aspheric, silicone, and acrylic intraocular lenses. Prospective evaluation. J Cataract Refract Surg, 2003, 29(9): 1684-1694.
8. Packer M, Fine IH, Hoffman RS. Aspheric intraocular lens selection: the evolution of refractive cataract surgery. Curr Opin Ophthalmol, 2008, 19(1): 1-4.
9. Rocha KM, Soriano ES, Chamon W, et al. Spherical Aberration and Depth of Focus in Eyes Implanted with Aspheric and Spherical Intraocular Lenses A Prospective Randomized Study. Ophthalmology, 2007, 114: 2050-2054.
10. Mu?oz G, Albarrán-Diego C, Montés-Micó R, et al. Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens. J Cataract Refract Surg, 2006, 32(8): 1320-1327.
11. Kasper T, Bühren J, Kohnen T. Visual performance of aspherical and spherical intraocular lenses: Intraindividual comparison of visual acuity, contrast sensitivity, and higher-order aberrations. J Cataract Refract Surg, 2006, 32(12): 2022-2029.
12. Denoyer A, Le Lez ML, Majzoub S, et al. Quality of vision after cataract surgery after Tecnis Z9000 intraocular lens implantation Effect of contrast sensitivity and wavefront aberration improvements on the quality of daily vision. J Cataract Refract Surg, 2007, 33(2): 210-216.
13. Johansson B, Sundelin S, Wikberg-Matsson A, et al. Visual and optical performance of the Akreos Adapt Advanced Optics and Tecnis Z9000 intraocular lenses Swedish multicenter study. J Cataract Refract Surg, 2007, 33(9): 1565-1572.
14. Higgins JPT, Sally Green, editors. Cochrane Reviewers’ Handbook Version 5.0.0. http://www.cochrane.org/resources/handbook/hbook. htm.
15. Higgins JPT, Altman DG (editors): Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. The Cochrane Collaboration, 2008. Available from www.cochranehandbook. org.
16. 吳泰相, 劉關鍵. 隱蔽分鰈 (分配隱藏) 和盲法的概念、實施與報告. 中國循證醫學雜志, 2007, 7(3): 203-207.
17. The Moorfields IOL Study Group. Binocular implantation of the Tecnis Z9000 or AcrySof MA60AC intraocular lens in routine cataract surgery Prospective randomized controlled trial comparing VF-14 scores. J Cataract Refract Surg, 2007, 33: 1559-1564.
18. Bellucci R, Morselli S, Pucci V. Spherical aberration and coma with an aspherical and a spherical intraocular lens in normal age-matched eyes. J Cataract Refract Surg, 2007, 33(2): 203-209.
19. Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J Cataract Refract Surg, 2007, 33(3): 497-509.
20. Beiko GH. Personalized correction of spherical aberration in cataract surgery. J Cataract Refract Surg, 2007, 33(8): 1455-1460.
21. Awwad ST, Warmerdam D, Bowman RW, et al. Contrast sensitivity and higher order aberrations in eyes implanted with AcrySof IQ SN60WF and AcrySof SN60AT intraocular lenses. J Refract Surg, 2008, 24(6): 619-625.
22. Tzelikis PF, Akaishi L, Trindade FC, et al. Ocular aberrations and contrast sensitivity after cataract surgery with AcrySof IQ intraocular lens implantation Clinical comparative study. J Cataract Refract Surg, 2007, 33(11): 1918-1924.
23. Casprini F, Balestrazzi A, Tosi GM, et al. Glare disability and spherical aberration with five foldable intraocular lenses: a prospective randomized study. Acta Ophthalmol Scand, 2005, 83(1): 20-25.
24. Tzelikis PF, Akaishi L, Trindade FC, et al. Spherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study. Am J Ophthalmol, 2008, 145(5): 827-833.
25. Caporossi A, Martone G, Casprini F, et al. Prospective randomized study of clinical performance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes. J Refract Surg, 2007, 23(7): 639-648.
26. Bellucci R, Scialdone A, Buratto L, et al. Visual acuity and contrast sensitivity comparison between Tecnis and AcrySof SA60AT intraocular lenses: A multicenter randomized study. J Cataract Refract Surg, 2005, 31(4): 712-717.
27. Lin IC, Wang IJ, Lei MS, et al. Improvements in vision-related quality of life with AcrySof IQ SN60WF aspherical intraocular lenses. J Cataract Refract Surg, 2008, 34(8): 1312-1317.
28. Pandita D, Raj SM, Vasavada VA, et al. Contrast sensitivity and glare disability after implantation of AcrySof IQ Natural aspherical intraocular lens Prospective randomized masked clinical trial. J Cataract Refract Surg, 2007, 33(4): 603-610.
29. Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg, 2002, 18(6): 683-691.
30. Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J Cataract Refract Surg, 2007, 33(3): 497-509.
31. Milauskas AT. Posterior capsule opacification after silicone lens implantation and its management. J Cataract Refract Surg, 1987, 13(6): 644-648.
32. Findl O, Buehl W, Bauer P, et al. Interventions for preventing posterior capsule opacification. Cochrane Database Syst Rev, 2007, (3): CD003738.

《中國循證醫學雜志》

球面人工晶狀體與非球面人工晶狀體臨床應用效果的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

下一篇

Format

Content

《中國循證醫學雜志》

球面人工晶狀體與非球面人工晶狀體臨床應用效果的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料