Cornea · 2016
Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty: A Meta-Analysis of Randomized Controlled Trials.
СтатьяМетаанализНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chen Guohai, Tzekov Radouil, Li Wensheng, Jiang Fangzheng, Mao Sihong, Tong Yuhua
Аннотация
PURPOSE: To evaluate the efficacy and safety of deep anterior lamellar keratoplasty (DALK) compared with penetrating keratoplasty (PK) for patients who had corneal stromal pathologies without endothelial abnormalities.
METHODS: We performed a meta-analysis using databases including PUBMED, EMBASE, and ClinicalTrials.gov to find relevant randomized controlled trials. Efficacy parameters were the postoperative best-corrected visual acuity, uncorrected visual acuity, and refractive error. Safety parameters were postoperative endothelial cell loss and graft rejection.
RESULTS: Five randomized controlled trials were selected for this meta-analysis, including 409 eyes (217 eyes in the DALK group and 192 eyes in the PK group). Postoperative logarithm of the minimum angle of resolution BCVA and UCVA were significantly better for PK than that for DALK [weighted mean difference (WMD) = 0.04, 95% confidence interval (CI), 0.01-0.07, P = 0.005 and WMD = 0.12, 95% CI, 0.05-0.18, P = 0.0007, respectively], whereas, the proportion of patients whose postoperative best-corrected visual acuity ≥ 20/40 did not differ statistically [risk ratio (RR) = 0.97, 95% CI, 0.89-1.07, P = 0.57]. There were no significant differences in terms of refractive error either by spherical equivalent or astigmatism (P = 0.11 and P = 0.25, respectively). The endothelial cell loss percentage in the PK group was significantly higher compared with the DALK group (WMD = -8.75, 95% CI, -15.25 to -2.25, P = 0.008). The DALK group was associated with a significantly lower frequency of graft rejection and endothelial rejection than the PK group (RR = 0.48, 95% CI, 0.28-0.82, P = 0.007 and RR = 0.07, 95% CI, 0.01-0.35, P = 0.001, respectively).
CONCLUSIONS: DALK is an alternative surgical procedure for corneal stromal pathologies without endothelial abnormalities, with lower efficacy but better safety.
METHODS: We performed a meta-analysis using databases including PUBMED, EMBASE, and ClinicalTrials.gov to find relevant randomized controlled trials. Efficacy parameters were the postoperative best-corrected visual acuity, uncorrected visual acuity, and refractive error. Safety parameters were postoperative endothelial cell loss and graft rejection.
RESULTS: Five randomized controlled trials were selected for this meta-analysis, including 409 eyes (217 eyes in the DALK group and 192 eyes in the PK group). Postoperative logarithm of the minimum angle of resolution BCVA and UCVA were significantly better for PK than that for DALK [weighted mean difference (WMD) = 0.04, 95% confidence interval (CI), 0.01-0.07, P = 0.005 and WMD = 0.12, 95% CI, 0.05-0.18, P = 0.0007, respectively], whereas, the proportion of patients whose postoperative best-corrected visual acuity ≥ 20/40 did not differ statistically [risk ratio (RR) = 0.97, 95% CI, 0.89-1.07, P = 0.57]. There were no significant differences in terms of refractive error either by spherical equivalent or astigmatism (P = 0.11 and P = 0.25, respectively). The endothelial cell loss percentage in the PK group was significantly higher compared with the DALK group (WMD = -8.75, 95% CI, -15.25 to -2.25, P = 0.008). The DALK group was associated with a significantly lower frequency of graft rejection and endothelial rejection than the PK group (RR = 0.48, 95% CI, 0.28-0.82, P = 0.007 and RR = 0.07, 95% CI, 0.01-0.35, P = 0.001, respectively).
CONCLUSIONS: DALK is an alternative surgical procedure for corneal stromal pathologies without endothelial abnormalities, with lower efficacy but better safety.