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Wavefront-guided versus non-wavefront-guided photorefractive keratectomy for myopia: meta-analysis of randomized controlled trials.

Kobashi H, Kamiya K, Hoshi K, Igarashi A, Shimizu K - PLoS ONE (2014)

Bottom Line: The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability.In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower.According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

ABSTRACT

Purpose: To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided photorefractive keratectomy (PRK).

Methods: The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trials. Trials meeting the selection criteria were quality appraised, and data was extracted by 2 independent authors. Measures of association were pooled quantitatively using meta-analytical methods. Comparisons between wavefront-guided and non-wavefront-guided ablations were made as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean differences and 95% CIs were used to compare induced HOAs.

Results: The study covered five trials involving 298 eyes. After wavefront-guided PRK, the pooled OR of achieving an uncorrected distance visual acuity of 20/20 (efficacy) was 1.18 (95% CI, 0.53-2.60; p = 0.69), the pooled OR of achieving a result within ±0.50 diopter of the intended target (predictability) was 0.86 (95% CI, 0.40-1.84; p = 0.70). No study reported a loss of 2 or more lines of Snellen acuity (safety) with either modality. In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower. There were no significant differences between the two groups in the postoperative total HOAs (mean difference -0.04; 95% CI, -0.23 to 0.14; p = 0.63), spherical (mean difference 0.00; 95% CI, -0.08 to 0.09; p = 0.93), and coma (mean difference -0.06; 95% CI, -0.14 to 0.03; p = 0.20) aberrations.

Conclusions: According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.

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Related in: MedlinePlus

Funnel plots showing the distribution between studies comparing each outcome.A, Efficacy, B, Predictability, C, Total HOAs. D, Spherical aberration. E, Coma aberration. F, Trefoil aberration.
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pone-0103605-g006: Funnel plots showing the distribution between studies comparing each outcome.A, Efficacy, B, Predictability, C, Total HOAs. D, Spherical aberration. E, Coma aberration. F, Trefoil aberration.

Mentions: The publication bias was independently assessed graphically for each clinical outcome using funnel plots (Figure 6). For efficacy and predictability, each study was plotted with the OR against the standard error as a measure of weighting. For aberrations, each study was plotted with the weighted mean difference against the standard error as a measure of weighting. There was an almost equal distribution between studies with a low and high OR/weighted mean difference and a low and high standard error for efficacy, predictability, and trefoil aberration.


Wavefront-guided versus non-wavefront-guided photorefractive keratectomy for myopia: meta-analysis of randomized controlled trials.

Kobashi H, Kamiya K, Hoshi K, Igarashi A, Shimizu K - PLoS ONE (2014)

Funnel plots showing the distribution between studies comparing each outcome.A, Efficacy, B, Predictability, C, Total HOAs. D, Spherical aberration. E, Coma aberration. F, Trefoil aberration.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4114780&req=5

pone-0103605-g006: Funnel plots showing the distribution between studies comparing each outcome.A, Efficacy, B, Predictability, C, Total HOAs. D, Spherical aberration. E, Coma aberration. F, Trefoil aberration.
Mentions: The publication bias was independently assessed graphically for each clinical outcome using funnel plots (Figure 6). For efficacy and predictability, each study was plotted with the OR against the standard error as a measure of weighting. For aberrations, each study was plotted with the weighted mean difference against the standard error as a measure of weighting. There was an almost equal distribution between studies with a low and high OR/weighted mean difference and a low and high standard error for efficacy, predictability, and trefoil aberration.

Bottom Line: The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability.In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower.According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

ABSTRACT

Purpose: To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided photorefractive keratectomy (PRK).

Methods: The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trials. Trials meeting the selection criteria were quality appraised, and data was extracted by 2 independent authors. Measures of association were pooled quantitatively using meta-analytical methods. Comparisons between wavefront-guided and non-wavefront-guided ablations were made as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean differences and 95% CIs were used to compare induced HOAs.

Results: The study covered five trials involving 298 eyes. After wavefront-guided PRK, the pooled OR of achieving an uncorrected distance visual acuity of 20/20 (efficacy) was 1.18 (95% CI, 0.53-2.60; p = 0.69), the pooled OR of achieving a result within ±0.50 diopter of the intended target (predictability) was 0.86 (95% CI, 0.40-1.84; p = 0.70). No study reported a loss of 2 or more lines of Snellen acuity (safety) with either modality. In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower. There were no significant differences between the two groups in the postoperative total HOAs (mean difference -0.04; 95% CI, -0.23 to 0.14; p = 0.63), spherical (mean difference 0.00; 95% CI, -0.08 to 0.09; p = 0.93), and coma (mean difference -0.06; 95% CI, -0.14 to 0.03; p = 0.20) aberrations.

Conclusions: According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.

Show MeSH
Related in: MedlinePlus