Abstract
BackgroundAccurate measurement of intraocular pressure (IOP) after corneal refractive surgery is of great significance to clinic, and comparisons among various IOP measuring instruments are not rare, but there is a lack of unified analysis. Although Goldmann Applanation Tonometer (GAT) is currently the internationally recognized gold standard for IOP measurement, its results are severely affected by central corneal thickness (CCT). Ocular Response Analyzer (ORA) takes certain biomechanical properties of cornea into account and is supposed to be less dependent of CCT. In this study, we conducted the meta-analysis to systematically assess the differences and similarities of IOP values measured by ORA and GAT in patients after corneal refractive surgery from the perspective of evidence-based medicine.MethodsThe authors searched electronic databases (MEDLINE, EMBASE, Web of science, Cochrane library and Chinese electronic databases of CNKI and Wanfang) from Jan. 2005 to Jan. 2019, studies describing IOP comparisons measured by GAT and ORA after corneal refractive surgery were included. Quality assessment, subgroup analysis, meta-regression analysis and publication bias analysis were applied in succession.ResultsAmong the 273 literatures initially retrieved, 8 literatures (13 groups of data) with a total of 724 eyes were included in the meta-analysis, and all of which were English literatures. In the pooled analysis, the weighted mean difference (WMD) between IOPcc and IOPGAT was 2.67 mmHg (95% CI: 2.20~3.14 mmHg, p < 0.0001), the WMD between IOPg and IOPGAT was − 0.27 mmHg (95% CI: − 0.70~0.16 mmHg, p = 0.2174). In the subgroup analysis of postoperative IOPcc and IOPGAT, the heterogeneity among the data on surgical procedure was zero, while the heterogeneity of other subgroups was still more than 50%. The comparison of the mean difference of pre- and post-operative IOP (∆IOP) was: mean-∆IOPg > mean-∆IOPGAT > mean-∆IOPcc.ConclusionsIOPcc, which is less dependent on CCT, may be more close to the true IOP after corneal refractive surgery compared with IOPg and IOPGAT, and the recovery of IOPcc after corneal surface refractive surgery may be more stable than that after lamellar refractive surgery.
Highlights
Corneal refractive surgery has become an extremely popular procedure to correct ametropia, such as myopia and hyperopia [1]
In the subgroup analysis of postoperative Corneal-Compensated Intraocular Pressure (IOPcc) and Intraocular pressure measured by GAT (IOPGAT), as shown in Table 2, the heterogeneity among the data on surgical procedure was zero, while the heterogeneity of other subgroups was still more than 50%
In the matter of comparison between Goldmann-correlated Intraocular Pressure (IOPg) and IOPGAT after corneal refractive surgery, our result showed that there was no significant difference between IOPg and IOPGAT
Summary
Corneal refractive surgery has become an extremely popular procedure to correct ametropia, such as myopia and hyperopia [1]. No matter what kind of refractive surgery the patient had undergone, their central corneal thicknesses (CCT) decreased, and corneal thickness affected the measured intraocular pressure (IOP) [3]. There are risks of steroid-induced glaucoma and secondary keratoconus after corneal refractive surgery, so it is of great clinical significance to accurately measure postoperative IOP for the diagnosis and treatment of ophthalmology [4]. Accurate measurement of intraocular pressure (IOP) after corneal refractive surgery is of great significance to clinic, and comparisons among various IOP measuring instruments are not rare, but there is a lack of unified analysis. We conducted the meta-analysis to systematically assess the differences and similarities of IOP values measured by ORA and GAT in patients after corneal refractive surgery from the perspective of evidence-based medicine
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
