硅膠和聚甲基丙烯酸甲酯人工晶狀體對晶狀體后囊混濁影響的系統評價_《中國循證醫學雜志》

作者：

李妮 , 劉誼 , 張軍軍 , 周勇

四川大學華西醫院眼科,成都,610041;

關鍵詞：

人工晶狀體硅膠聚甲基丙烯酸甲酯后囊混濁系統評價

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目的　評價白內障摘除聯合人工晶狀體術后植入硅膠(silicone)與聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA)人工晶狀體對晶狀體后囊混濁(posterior capsule opacification, PCO)影響的差異.
方法　計算機檢索MEDLINE(1966～2003)、EMBASE(1980～2003)、Cochrane圖書館臨床對照試驗資料庫(2003年第1期)和中國生物醫學文獻光盤數據庫(1979～2003),收集有關比較PMMA和Silicone兩種材料的人工晶狀體植入對PCO形成影響的隨機對照試驗(RCT),由兩位研究者獨立進行質量評價、資料提取,并進行交叉核對.采用RevMan 4.2進行Meta分析.
結果　共納入9篇RCT,672只眼.老年性白內障亞組的Meta分析結果顯示,在PCO程度[SMD合并=-0.92, 95%CI (-1.19,-0.64)]和Nd:YAG激光后囊切開率[OR合并=0.35, 95%CI (0.22,0.57)]方面,Silicone組明顯低于PMMA組,其差異有統計學意義;在術后視力方面,其差異無統計學意義[OR合并=1.22, 95%CI (0.43,3.50)].葡萄膜炎并發白內障亞組的Meta分析結果顯示,在術后視力方面,PMMA組較Silicone組為好,其差異有統計學意義[OR合并=0.38, 95%CI (0.15,0.91)];在PCO程度[SMD=0.23, 95%CI (-0.59, 1.05)]和Nd:YAG激光后囊切開率[OR合并=1.82, 95%CI (0.47,6.95)]方面,其差異無統計學意義.
結論　現有資料表明,在降低PCO方面,老年性白內障患者選用Silicone優于PMMA;由于納入研究少,葡萄膜炎并發白內障患者選用何種材料人工晶狀體較好,尚不能得出肯定結論.

引用本文： 李妮,劉誼,張軍軍,周勇. 硅膠和聚甲基丙烯酸甲酯人工晶狀體對晶狀體后囊混濁影響的系統評價. 中國循證醫學雜志, 2005, 05(2): 125-129. doi: 復制

1.	Ridley H. Intraocular Acrylic Lenses[J]. Trans Ophthalmol Soc UK, 1951;71: 617-621.
2.	Schaumberg DA, Dana MR, Christen WG, Glynn RJ. A systematic overview of the incidence of posterior capsule opacification[J]. Ophthalmology, 1998;105(7): 1 213-1 221.
3.	Jadad AR, Moore RA, Carroll D. Assessing the quality of reports of randomized clinical trials: is blinding necessary[J]? Controlled Clinical Trials, 1996;17: 1-12.
4.	Olson RJ, Crandall AS. Silicone versus polymethylmethacrylate intraocular lenses with regard to capsular opacification[J]. Ophthalmic Surg Lasers, 1998;29(1): 55-58.
5.	Ursell PG, Spalton DJ, Pande MV, Hollick EJ, Barman S, Boyce J, Tilling K. Relationship between intraocular lens biomaterials and posterior capsule opacification[J]. J Cataract Refract Surg, 1998;24(3): 352-360.
6.	Hayashi H, Hayashi K, Nakao F, Hayashi F. Quantitative comparison of intraocular lens implantation[J]. Arch Ophthalmol, 1998;116(12): 1 579- 1 582.
7.	Hollick EJ, Spalton DJ, Ursell PG, Pande MV, Barman SA, Boyce JF, Tilling K. The effect of polymethylmethacrylate, silicone, and polyacrylic intraocular lenses on posterior capsular opacification 3 years after cataract surgery[J]. Ophthalmology, 1999;106(1): 49-55.
8.	Wang MC, Woung LC. Digital retroilluminated photography to analyze posterior capsule opacification in eyes with intraocular lenses[J]. J Cataract Refract Surg, 2000;26(1): 56-61.
9.	Hollick EJ, Spalton DJ, Ursell PG, Meacock WR, Barman SA, Boyce JF. Posterior capsular opacification with hydrogel, polymethylmethacrylate, and silicone intraocular lenses: two-year results of a randomized prospective trial[J]. Am J Ophthalmol, 2000;129(5): 577-584.
10.	Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in posterior capsule opacification after poly (methyl methacrylate), silicone, and acrylic intraocular lens implantation[J]. J Cataract Refract Surg, 2001;27(6): 817-824.
11.	Alio JL, Chipont E, BenEzra D, Fakhry MA. International Ocular Inflammation Society, Study Group of Uveitic Cataract Surgery. Comparative performance of intraocular lenses in eyes with cataract and uveitis[J]. J Cataract Refract Surg, 2002;28(12): 2 096-2 108.
12.	Papaliodis GN, Nguyen QD, Samson CM, Foster CS. Intraocular lens tolerance in surgery for cataracta complicata: assessment of four implant materials[J]. Semin Ophthalmol, 2002;17(3-4): 120-123.

1. Ridley H. Intraocular Acrylic Lenses[J]. Trans Ophthalmol Soc UK, 1951;71: 617-621.
2. Schaumberg DA, Dana MR, Christen WG, Glynn RJ. A systematic overview of the incidence of posterior capsule opacification[J]. Ophthalmology, 1998;105(7): 1 213-1 221.
3. Jadad AR, Moore RA, Carroll D. Assessing the quality of reports of randomized clinical trials: is blinding necessary[J]? Controlled Clinical Trials, 1996;17: 1-12.
4. Olson RJ, Crandall AS. Silicone versus polymethylmethacrylate intraocular lenses with regard to capsular opacification[J]. Ophthalmic Surg Lasers, 1998;29(1): 55-58.
5. Ursell PG, Spalton DJ, Pande MV, Hollick EJ, Barman S, Boyce J, Tilling K. Relationship between intraocular lens biomaterials and posterior capsule opacification[J]. J Cataract Refract Surg, 1998;24(3): 352-360.
6. Hayashi H, Hayashi K, Nakao F, Hayashi F. Quantitative comparison of intraocular lens implantation[J]. Arch Ophthalmol, 1998;116(12): 1 579- 1 582.
7. Hollick EJ, Spalton DJ, Ursell PG, Pande MV, Barman SA, Boyce JF, Tilling K. The effect of polymethylmethacrylate, silicone, and polyacrylic intraocular lenses on posterior capsular opacification 3 years after cataract surgery[J]. Ophthalmology, 1999;106(1): 49-55.
8. Wang MC, Woung LC. Digital retroilluminated photography to analyze posterior capsule opacification in eyes with intraocular lenses[J]. J Cataract Refract Surg, 2000;26(1): 56-61.
9. Hollick EJ, Spalton DJ, Ursell PG, Meacock WR, Barman SA, Boyce JF. Posterior capsular opacification with hydrogel, polymethylmethacrylate, and silicone intraocular lenses: two-year results of a randomized prospective trial[J]. Am J Ophthalmol, 2000;129(5): 577-584.
10. Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in posterior capsule opacification after poly (methyl methacrylate), silicone, and acrylic intraocular lens implantation[J]. J Cataract Refract Surg, 2001;27(6): 817-824.
11. Alio JL, Chipont E, BenEzra D, Fakhry MA. International Ocular Inflammation Society, Study Group of Uveitic Cataract Surgery. Comparative performance of intraocular lenses in eyes with cataract and uveitis[J]. J Cataract Refract Surg, 2002;28(12): 2 096-2 108.
12. Papaliodis GN, Nguyen QD, Samson CM, Foster CS. Intraocular lens tolerance in surgery for cataracta complicata: assessment of four implant materials[J]. Semin Ophthalmol, 2002;17(3-4): 120-123.

《中國循證醫學雜志》

硅膠和聚甲基丙烯酸甲酯人工晶狀體對晶狀體后囊混濁影響的系統評價

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《中國循證醫學雜志》

硅膠和聚甲基丙烯酸甲酯人工晶狀體對晶狀體后囊混濁影響的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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