Corneal Surface Ablation Laser Refractive Surgery for the Correction of Myopia: A Network Meta-analysis

• DOI: 10.3928/1081597x-20180905-01
• Publication Date: 2018-11-14T19:24:28Z
• Authors: Daizong Wen; Ruixue Tu; Ian Flitcroft; Qinmei Wang; Yingying Huang; Benhao Song; Ayong Yu; Liang Hu; Yune Zhao; Fangjun Bao; Ye Yu; Hengli Lian; Louis Hoffart; Robert Lee Kramm; Eirini Skiadaresi; David O'Brart; Ioannis Pallikaris; John Marshall; Colm McAlinden; Jinhai Huang
• Keywords: Refractive Surgery; LASIK

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, U.S. trial registry were searched up to June 2018. Randomized controlled trials selected. Efficacy (uncorrected distance visual acuity 20/20 or better), predictability (refractive spherical equivalent within ±0.50 diopters [D] target), safety (loss two more lines spectacle corrected acuity) set as primary outcome measures. Haze, secondary RESULTS: Eighteen studies involving 1,423 eyes included. According Grading Recommendations Assessment, Development, Evaluation, quality outcomes moderate high (70.6%). There no differences in day 1 pain, between treatments. Epithelial laser situ keratomileusis (epi-LASIK) had statistically significantly higher scores on 3 compared photorefractive keratectomy (PRK) (weighted mean [WMD] = 2.2, 95% credible intervals [CrI] 0.19 4.01) transepithelial PRK (T-PRK) (WMD 2.7, CrI 0.51 4.84). The under cumulative ranking curve results (best worst) showed (LASEK) ranked highest for scores. Epi-LASIK best grade haze T-PRK 0.5 higher, time. CONCLUSIONS: Surface refractive surgeries are comparable terms except with epi-LASIK being painful T-PRK. [ J Refract Surg . 2018;34(11):726–735.]