Meta-analysis Of Clinical Randomized Controlled Trials Comparing Refractive With Diffractive Multifocal Intraocular Lenses In The Treatment Of Cataract Surgery

Objective To systematic review the effectiveness of refractive multifocalintraocular lens (MIOL) versus diffractive MIOL in the treatment of cataract.Method Randomized controlled trials comparing refractive MIOL withdiffractive MIOL were identified by searching PubMed (1966to May,2013), EMbase(1980to May,2013), MEDLINE (1966to May,2013), and The Cochrane Library(Issue1,2013). We also hand-searched related journals. All the searches were restrictedin English or Chinese. Methodological quality of randomized controlled trials (RCTs)was evaluated by simple evaluate method that recommended by the CochraneCollaboration. Data extracted by two reviewers with designed extraction form. RevMansoftware (release5.2) was used for data management and analysis.Results A total of11trials (1580eyes) were included for systematic review.Subgroup analyses were used according to different model comparison of MIOL. Theresults showed a significant difference in the mean of the uncorrected distance visualacuity (UCDVA) and the uncorrected intermediate visual acuity (UCIVA) in therefractive MIOL group with MD-0.04,95%CI-0.06to-0.03(P<0.0001) and MD-0.05,95%CI-0.09to-0.02(P=0.001). It showed a significantly difference in the meanof the uncorrected near visual acuity (UCNVA), complete spectacle independent rate,halo rate and glare rate in the diffractive MIOL group with MD0.11,95%CI0.08to0.15(P<0.00001), MD2.98,95%CI2.17to4.09(P<0.00001), MD1.52,95%CI1.14to2.04(P=0.004) and MD1.27,95%CI1.07to1.50(P=0.005). There was no significant difference between the two groups in the mean of the best corrected distance visualacuity (BCDVA), the best distance corrected intermediate visual acuity (BDCIVA), thebest distance corrected near visual acuity (BDCNVA) and the best corrected near visualacuity (BCNVA) with MD-0.01,95%CI–0.03to0.01(P=0.45), MD-0.06,95%CI–0.15to0.03(P=0.18), MD0.08,95%CI–0.01to0.17(P=0.09) and MD-0.00,95%CI–0.01to0.01(P=0.83).Conclusion Patients implanted with refractive MIOL show better uncorrecteddistance and intermediate visual acuity; patients implanted with diffractive MIOL showbetter uncorrected near visual acuity with less likely to appear light halo, glare and othervisual adverse reactions; As for spectacles correction cases, patients implanted withdiffractive or refractive MIOL have considerable performances in the far, middle, nearvisual acuity.