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Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia
| Content Provider | Scilit |
|---|---|
| Author | Shortt, Alex J. Allan, Bruce Ds Evans, Jennifer R. |
| Copyright Year | 2013 |
| Description | Journal: Cochrane Database of Systematic Reviews |
| Abstract | Myopia (also known as short‐sightedness or near‐sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser‐assisted in‐situ keratomileusis (LASIK). To compare the effectiveness and safety of LASIK and PRK for correction of myopia by examining post‐treatment uncorrected visual acuity, refractive outcome, loss of best spectacle‐corrected visual acuity, pain scores, flap complications in LASIK, subepithelial haze, adverse events, quality of life indices and higher order aberrations. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In‐Process and Other Non‐Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled‐trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 November 2012. We also searched the reference lists of the studies and the Science Citation Index. We included randomised controlled trials comparing LASIK and PRK for the correction of any degree of myopia. Two authors independently assessed trial quality and extracted data. We summarised data using the odds ratio and mean difference. We combined odds ratios using a random‐effects model after testing for heterogeneity. We included 13 trials (1135 participants, 1923 eyes) in this review. Nine of these trials randomised eyes to treatment, two trials randomised people to treatment and treated both eyes, and two trials randomised people to treatment and treated one eye. None of the paired trials reported an appropriate paired analysis. We considered the overall quality of evidence to be low for most outcomes because of the risk of bias in the included trials. There was evidence that LASIK gives a faster visual recovery than PRK and is a less painful technique. Results at one year after surgery were comparable: most analyses favoured LASIK but they were not statistically significant. LASIK gives a faster visual recovery and is a less painful technique than PRK. The two techniques appear to give similar outcomes one year after surgery. Further trials using contemporary techniques are required to determine whether LASIK and PRK as currently practised are equally safe. Randomising eyes to treatment is an efficient design, but only if analysed properly. In future trials, more efforts could be made to mask the assessment of outcome. Kératomileusis in situ assisté par laser (LASIK) versus photokératectomie réfractive (PKR) pour la myopie La myopie est une affection oculaire dans laquelle la puissance de réfraction de l'œil est plus importante que nécessaire, faisant que la lumière provenant des objets éloignés est focalisée devant la rétine plutôt que précisément sur celle‐ci. Les deux techniques chirurgicales les plus couramment utilisées pour corriger définitivement la myopie sont la photokératectomie réfractive (PKR) et le kératomileusis in situ assisté par laser (LASIK). Comparer l'efficacité et la sécurité du LASIK et de la PKR pour la correction de la myopie en examinant l'acuité visuelle non corrigée après traitement, la réfraction obtenue, la perte de la bonne correction de l'acuité visuelle conférée par les lunettes, les scores de douleur, les complications de lambeaux avec le LASIK, le voile sous‐épithélial, les événements indésirables, les indices de qualité de vie et les aberrations d'ordre supérieur. Nous avons effectué une recherche dans CENTRAL (qui contient le registre des essais du groupe Cochrane sur l'ophtalmologie) (The Cochrane Library 2012, numéro 11), Ovid MEDLINE, Ovid MEDLINE In‐Process and Other Non‐Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (de janvier 1946 à novembre 2012), EMBASE (de janvier 1980 à novembre 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (de janvier 1982 à novembre 2012), le métaRegistre des essais contrôlés (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) et le système d'enregistrement international des essais cliniques de l'OMS (ICTRP) (www.who.int/ictrp/search/fr). Pour les recherches électroniques d'essais nous n'avons appliqué aucune restriction concernant la date ou la langue. Nous avons consulté les bases de données électroniques pour la dernière fois le 15 novembre 2012. Nous avons également passé au crible les références bibliographiques des études, ainsi que le Science Citation Index. Nous avons inclus des essais contrôlés randomisés ayant comparé le LASIK et la PKR pour la correction de la myopie, quel que soit le degré de celle‐ci. Deux auteurs ont évalué la qualité méthodologique des essais et extrait les données de manière indépendante. Nous avons... |
| Related Links | http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005135.pub3/pdf |
| ISSN | 1469493X |
| e-ISSN | 14651858 |
| DOI | 10.1002/14651858.cd005135.pub3 |
| Journal | Cochrane Database of Systematic Reviews |
| Issue Number | 1 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2013-01-31 |
| Access Restriction | Open |
| Subject Keyword | Journal: Cochrane Database of Systematic Reviews Caribbean Literature |
| Content Type | Text |
| Resource Type | Article |
