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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Efficacy, predictability, and safety of wavefront-guided refractive laser treatment: metaanalysis

Review published: 2011.

Bibliographic details: Fares U, Suleman H, Al-Aqaba MA, Otri AM, Said DG, Dua HS.  Efficacy, predictability, and safety of wavefront-guided refractive laser treatment: metaanalysis. Journal of Cataract and Refractive Surgery 2011; 37(8): 1465-1475. [PubMed: 21782089]


PURPOSE: To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided ablations.

SETTING: Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, United Kingdom.

DESIGN: Metaanalysis.

METHODS: The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trails. Trials meeting the selection criteria were quality appraised and data extracted by 2 independent authors. Measures of association were pooled quantitatively using metaanalytical methods. Comparison between wavefront-guided and non-wavefront-guided ablations was measured 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 difference and 95% CIs were used to compare induced HOAs.

RESULTS: Eight trials involving 955 eyes were included. After wavefront-guided LASIK, the pooled OR of achieving uncorrected distance visual acuity (UDVA) of 20/20 (efficacy) was 1.10 (95% CI, 0.66-1.83; P=.72), the pooled OR of achieving a result within ± 0.50 diopter of intended target (predictability) was 1.03 (95% CI, 0.60-1.75; P=.92), and the weighted mean difference in induced HOAs was -0.09 (95% CI, -0.17 to -0.01; P=.04). No study reported loss of 2 or more lines of Snellen acuity (safety) with either modality.

CONCLUSIONS: Metaanalysis showed no clear evidence of a benefit of wavefront-guided over non-wavefront-guided ablations. However, there was a lack of standardized reporting of UDVA better than 20/20, which might mask an advantage in wavefront-guided treatment. With high preexisting HOAs, wavefront-guided has advantages over non-wavefront-guided treatment.

Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

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