[1]郝壮,赵超,蒋孟琪,等.囊袋张力环对高度近视患者白内障术后疗效影响的荟萃分析[J].眼科新进展,2023,43(1):047-52.[doi:10.13389/j.cnki.rao.2023.0010]
　HAO Zhuang,ZHAO Chao,JIANG Mengqi,et al.Meta-analysis on the roles of capsular tension ring in cataract surgery efficacy of patients with high myopia[J].Recent Advances in Ophthalmology,2023,43(1):047-52.[doi:10.13389/j.cnki.rao.2023.0010]
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囊袋张力环对高度近视患者白内障术后疗效影响的荟萃分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年1期
页码:
047-52
栏目:
应用研究
出版日期:
2023-01-05

文章信息/Info

Title:
Meta-analysis on the roles of capsular tension ring in cataract surgery efficacy of patients with high myopia
作者:
郝壮; 赵超; 蒋孟琪; 张泸宁; 马济远; 何梦梅; 周健
710032　陕西省西安市，空军军医大学西京医院眼科，全军眼科研究所（郝壮，赵超，蒋孟琪，张泸宁，马济远，何梦梅，周健）；130000　吉林省长春市，空军航空大学门诊部（郝壮）
Author(s):
HAO Zhuang1; 2; ZHAO Chao1; JIANG Mengqi1; ZHANG Luning1; MA Jiyuan1; HE Mengmei1; ZHOU Jian1
1.Department of Ophthalmology,Xijing Hospital,Air Force Medical University，Eye Institute of PLA,Xi’an 710032,Shaanxi Province,China
2.Department of Clinics,Aviation University of Air Force,Changchun 130000,Jilin Province,China
关键词:
高度近视; 囊袋张力环; 白内障手术; 荟萃分析; 人工晶状体倾斜; 人工晶状体偏心; 后发性白内障; 囊袋皱缩
Keywords:
high myopia;  capsular tension ring;  cataract surgery;  meta-analysis;  inclination of intraocular lens;  eccentricity of intraocular lens;  posterior capsule opacification;  capsular bag shrinkage
分类号:
R776.1
DOI:
10.13389/j.cnki.rao.2023.0010
文献标志码:
A
摘要:
目的　基于荟萃分析评价术中联合植入囊袋张力环（CTR）对高度近视患者白内障手术疗效的影响。
方法　全面检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、万方、维普等7个数据库，检索时间范围为1990年1月1日至2022年3月20日，收集CTR在高度近视患者白内障手术中应用的随机对照试验和非随机对照试验。2名研究人员根据纳入和排除标准，独立检索文献、提取数据及进行方法学质量评价，采用Review Manager 5.4进行荟萃分析。
结果　最终纳入8篇文献，共涉及1292例（1630眼）患者。荟萃分析结果显示，在改善患者最佳矫正视力（BCVA）方面，术后1个月、3个月、6个月CTR联合人工晶状体（IOL）植入组患者的BCVA均显著优于IOL植入组（均为P<0.05）；在IOL倾斜角、偏心量方面，术后6个月时CTR联合IOL植入组患者较IOL植入组均显著降低（均为P<0.05）；晶状体前囊口面积方面，术后3个月时CTR联合IOL植入组患者大于IOL植入组（P=0.048）；术后PCO发生率方面，CTR联合IOL植入组患者显著低于IOL植入组（P<0.000 01）;术后3个月时CTR联合IOL植入组患者角膜内皮细胞密度与IOL植入组相比差异无统计学意义（P=0.48）。
结论　对于高度近视患者，在白内障术中植入CTR有助于患者获得更好的BCVA、减少术后IOL倾斜与偏心、降低PCO以及囊袋皱缩的发生。
Abstract:
Objective　To evaluate the effect of implanted capsular tension ring (CTR) on the cataract surgery of patients with high myopia.
Methods　Seven databases, including PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang Data and Weipu, were comprehensively searched with a time range from January 1, 1990 to March 20, 2022. Randomized controlled trials and non-randomized controlled trials of the application of CTR in cataract surgery of patients with high myopia were collected. Two researchers independently searched the literatures, extracted the data, and assessed methodological quality according to the inclusion and exclusion criteria. Meta-analysis was performed using Review Manager 5.4.
Results　Eight articles were finally included, involving 1292 patients (1630 eyes). Meta-analysis showed that the best corrected visual acuity (BCVA) of patients who underwent CTR combined with intraocular lens (IOL) implantation was significantly higher than that in the patients who underwent IOL implantation at 1 month, 3 months and 6 months after the surgery (all P<0.05). In the patients who underwent CTR combined with IOL implantation, the angle of inclination and eccentricity of IOL were significantly lower than those in the patients who underwent IOL implantation at 6 months after the surgery (both P<0.05). The anterior lens capsular orifice area in the patients who underwent CTR combined with IOL implantation was significantly higher than that in the patients who underwent IOL implantation 3 months after the surgery (P=0.048); the incidences of posterior capsule opacification (PCO) in the patients who underwent CTR combined with IOL implantation was significantly lower than that in the patients underwent IOL implantation (P<0.000 01). There was no significant difference in the endothelial cell density between the two groups 3 months after the surgery (P=0.48).
Conclusion　For high myopic patients, implanting CTR in cataract surgery is conducive to a higher BCVA, less inclination and eccentricity, lower incidences of PCO and capsular bag shrinkage.

参考文献/References:

［1］　HOLDEN B A,FRICKE T R,WILSON D A,JONG M,NAIDOO K S,SANKARIDURG P,et al.Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050［J］.Ophthalmology,2016,123(5):1036-1042.
［2］　IKUNO Y.Overview of the complications of high myopia［J］.Retina,2017,37(12):2347-2351.
［3］　YAO Y,LU Q,WEI L,CHENG K,LU Y,ZHU X.Efficacy and complications of cataract surgery in high myopia［J］.J Cataract Refract Surg,2021,47(11):1473-1480.
［4］　FAN Q,HAN X,LUO J,CAI L,QIU X,LU Y,et al.Risk factors of intraocular lens dislocation following routine cataract surgery:a case-control study［J］.Clin Exp Optom,2021,104(4):510-517.
［5］　RAI G,SAHAI A,KUMAR P R.Outcome of capsular tension ring (CTR) implant in complicated cataracts［J］.J Clin Diagn Res,2015,9(12):NC05-NC07.
［6］　MIYOSHI T,FUJIE S,YOSHIDA H,IWAMOTO H,TSUKAMOTO H,OSHIKA T.Effects of capsular tension ring on surgical outcomes of premium intraocular lens in patients with suspected zonular weakness［J］.PLoS One,2020,15(2):e0228999.
［7］　ALI J L,PLAZA-PUCHE A B,PIERO D P.Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring:refractive and visual outcomes and intraocular optical performance［J］.J Refract Surg,2012,28(4):253-258.
［8］　ZHANG K,DONG Y,ZHAO M,NIE L,DING X,ZHU C.The effect of capsule tension ring on posterior capsule opacification:a meta-analysis［J］.PLoS One,2021,16(3):e0246316.
［9］　范永琦,申飞,张晨霞,朱珂珂.超声乳化白内障摘出联合CTR植入治疗高度近视并发白内障［J］.国际眼科杂志,2021,21(9):1535-1538.
FAN Y Q,SHEN F,ZHANG C X,ZHU K K.Phacoemulsification combined with CTR implantation in the treatment of high myopia with cataract［J］.Int Eye Sci,2021,21(9):1535-1538.
［10］　YANG S,JIANG H,NIE K,FENG L,FAN W.Effect of capsular tension ring implantation on capsular stability after phacoemulsification in patients with weak zonules:a randomized controlled trial.CTR implantation in cataract patients with weak zonules［J］.BMC Ophthalmol,2021,21(1):19.
［11］　王洪亮,刘刚,贾万程.囊袋张力环植入在超高度近视并发白内障眼超声乳化白内障摘出术中的应用［J］.中华实验眼科杂志,2020,38(2):114-120.
WANG H L,LIU G,JIA W C.Application of capsular tension ring implantation during phacoemulsification for ultra-high myopia complicated with cataract［J］.Chin J Exp Ophthalmol,2020,38(2):114-120.
［12］　ZHAO Y,LI J,YANG K,LI X,ZHU S.Combined special capsular tension ring and toric IOL implantation for management of astigmatism and high axial myopia with cataracts［J］.Semin Ophthalmol,2018,33(3):389-394.
［13］　韩玉彤,陈彬川,朱光举,徐一帆,雷方.超声生物显微镜观察囊袋张力环应用后IOL的偏心量和倾斜度［J］.眼科新进展,2017,37(6):562-565.
HAN Y T,CHEN B C,ZHU G J,XU Y F,LEI F.Decentration and tilt of IOL after capsule tension ring implantation observed by ultrasonic biomicroscope［J］.Rec Adv Ophthalmol,2017,37(6):562-565.
［14］　KELES S,KARTAL B,APIL A,ONDAS O A,TOPDAGI E,EKINCI M,et al.Nd:YAG laser posterior capsulotomy rates in myopic eyes after implantation of capsular tension ring［J］.Med Sci Mon,2014,20:1469-1473.
［15］　HALILI I,MUTLU F M,ERDURMAN F C,GNDOGAN F C,KILIC S.Influence of capsular tension ring on posterior capsule opacification in myopic eyes［J］.Indian J Ophthalmol,2014,62(3):311-315.
［16］　彭华琮,袁媛,刘保松.晶状体囊袋张力环植入对高度近视白内障术后后发性白内障发生的影响［J］.眼科新进展,2010,30(11):1065-1067.
PENG H C,YUAN Y,LIU B S.Effects of capsular tension ring insertion on PCO formation after high myopic cataract surgery［J］.Rec Adv Ophthalmol,2010,30(11):1065-1067.
［17］　POTEMKIN V V,ASTAKHOV S Y,GOLTSMAN E V,YUAN V S.Assessment of risk factors for the development of late intraocular lens dislocation［J］.Oftalmologiya,2021,18(1):103-119.
［18］　JIANG H M,LIANG K,TAO L M.Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia［J］.Int J Ophthalmol,2021,14(3):378-382.
［19］　LEGLER U F C,WITSCHEL B M.The capsular ring:a new device for complicated cataract surgery［J］.German J Ophthalmol,1994,3:265,
［20］　WEBER C H,CIONNI R J.All about capsular tension rings［J］.Curr Opin Ophthalmol,2015,26(1):10-15.
［21］　NABH R,RAM J,PANDAV S S,GUPTA A.Visual performance and contrast sensitivity after phacoemulsification with implantation of aspheric foldable intraocular lenses［J］.J Cataract Refract Surg,2009,35(2):347-353.
［22］　GUYTON D L,UOZATO H,WISNICKI H J.Rapid determination of intraocular lens tilt and decentration through the undilated pupil［J］.Ophthalmology,1990,97(10):1259-1264.
［23］　BARANWAL V K,KUMAR S,MISHRA A,DUTTA A K.A study to evaluate whether CTR increases refractive unpredictability between predicted and actual IOL position［J］.Med J Armed Forces India,2014,70(1):36-38.
［24］　BELOV D,NIKOLAENKO V,POTEMKIN V.Effect of capsular tension ring implantation during phacoemulsification on postoperative refraction［J］.Eur J Ophthalmol,2022,32(4):2189-2193.
［25］　SCHILD A M,ROSENTRETER A,HELLMICH M,LAPPAS A,DINSLAGE S,DIETLEIN T S.Effect of a capsular tension ring on refractive outcomes in eyes with high myopia［J］.J Cataract Refract Surg,2010,36(12):2087-2093.
［26］　ALI J L,ELKADY B,ORTIZ D,BERNABEU G.Microincision multifocal intraocular lens with and without a capsular tension ring:optical quality and clinical outcomes［J］.J Cataract Refract Surg,2008,34(9):1468-1475.
［27］　KWON H,CHOI A,KIM B,JEON S.Effect of capsular tension ring on refractive outcomes in patients with implantation of the quadrifocal acrysof PanOptix TFNT00 IOL［J］.J Refract Surg,2021,37(3):174-179.
［28］　LEE G I,LIM D H,CHI S,KIM S W,HAN J,SHIN D W,et al.Incidence and characteristics of intraocular lens dislocation after phacoemulsification:an eight-year,nationwide,population-based study［J］.J Clin Med,2021,10(17):3830.
［29］　刘刚,王洪亮,贾万程,张淑萍,张春娣,裴响华，等.超声乳化术中联合应用囊袋张力环对不同眼轴长度超高度近视合并白内障患者的临床疗效［J］.眼科新进展,2020,40(5)：439-443.
LIU G,WANG H L,JIA W C,ZHANG S P,ZHANG C D,PEI X H,et al.Clinical effect of combined application of capsular tension ring implantation in patients having ultra-high myopia combined with cataract at different axial lengths［J］.Rec Adv Ophthalmol,2020,40(5):439-443.

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备注/Memo

备注/Memo:
空军军医大学临床研究项目（编号： 2021LC2219）；空军军医大学第一附属医院学科助推计划（编号： XJZT19D07）
更新日期/Last Update: 2023-01-05