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أعرض في EDS

Laser-based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta-analyses.

التفاصيل البيبلوغرافية
العنوان: Laser-based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta-analyses.
المؤلفون: Peñarrocha-Oltra S; Hospital Lluís Alcanyís, Xàtiva, Spain.; Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain., Soto-Peñaloza R; Ophthalmology Service, Luis Arias Schreiber Military Hospital, Lima, Peru., Alonso-Arroyo A; UISYS. Department of History of Science and Information Science, School of Medicine and Dentistry, University of Valencia, Valencia, Spain., Vidal-Infer A; UISYS. Department of History of Science and Information Science, School of Medicine and Dentistry, University of Valencia, Valencia, Spain., Pascual-Segarra J; Hospital Lluís Alcanyís, Xàtiva, Spain.
المصدر: Acta ophthalmologica [Acta Ophthalmol] 2022 Dec; Vol. 100 (8), pp. 878-893. Date of Electronic Publication: 2022 May 09.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford, UK : Wiley-Blackwell
Original Publication: Oxford, UK ; Malden, MA : Blackwell Munksgaard
مواضيع طبية MeSH: Myopia*/surgery , Keratectomy, Subepithelial, Laser-Assisted*/methods, Adult ; Humans ; Visual Acuity ; Systematic Reviews as Topic ; Lasers, Excimer/therapeutic use
مستخلص: Systematic reviews (SRs) and meta-analyses (MAs) are of great importance for basing clinical decisions. However, misleading interpretations may result when informed decisions rest on biased review papers with methodological issues. To evaluate which treatment is optimal, an overview was made of SRs and MAs to establish the quality and certainty of meta-evidence published on the efficacy of laser-based refractive surgery techniques for treating myopia in adults. A search was made in five databases and was updated using Really Simple Syndication (RSS) feed appliances up to April 2021; SRs with or without MAs were included. Methodological quality was appraised using the AMSTAR-2 tool. The best available reviews were summarized using the GRADE approach. The corrected covered area (CCA) was used to determine the degree of over-representation of publications. The risk of bias of the primary studies was disclosed visually. Thirty-six studies published between 2003 and 2021 were included. Twenty SRs (56%) were conducted in China. The most studied comparisons were SMILE versus FS-LASIK (19%) and FS-LASIK versus MM-LASIK (11%). Of the 251 overlapping index publications, 165 were unique (CCA = 0.015%), representing a negligible risk of skewed reporting. The AMSTAR-2 tool showed most SRs to have critically low or low quality. Nine reviews presented moderate quality. The GRADE approach of the 41 a priori outcomes evidenced critically low and low certainty of evidence. Only the spherical equivalent refraction changes at 12 months between LASEK and PRK showed moderate certainty of evidence, favouring PRK (mean difference 0.06, 95%CI [-0.02 to 0.14], I 2  = 0%; p ≥ 0.05). Index trials among less biased reviews are prone to selection, performance and reporting bias. The appraised techniques exhibit comparable results in terms of efficacy. There is moderate certainty of evidence in favour of the use of PRK over LASEK in terms of the spherical equivalent refraction error changes at 1 year of follow-up. Most appraised SRs presented methodological flaws in critical domains, resulting in a low to critically low certainty of evidence after GRADE appraisal. Therefore, investigators need to study and compare the different laser-based refractive techniques to provide better evidence-based medicine. Further well-designed, high-quality clinical trials and SRs are needed to reappraise the current findings.
(© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
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فهرسة مساهمة: Keywords: adults; evidence-based medicine; myopia; refractive error; refractive surgery; systematic review
تواريخ الأحداث: Date Created: 20220510 Date Completed: 20221114 Latest Revision: 20221229
رمز التحديث: 20221229
مُعرف محوري في PubMed: PMC9790262
DOI: 10.1111/aos.15160
PMID: 35535010
قاعدة البيانات: MEDLINE
الوصف
تدمد:1755-3768
DOI:10.1111/aos.15160