Meta Analysis Of The Effects Of Two Different Materials Of Intraocular Lenses On Posterior Capsular Opacification

Background and Aim:Posterior cataract(PCO)is caused by posterior capsular opacification(PCO)after cataract surgery,which is the main reason for the decrease of visual acuity(VA)after cataract surgery.Cataract surgery has developed to advanced phacoemulsif-ication of(PHACO),but the occurrence of postoperative PCO is still common.More and more attention has been paid to the prevention and treatment of PCO.For the development of PCO,the onset time and opacity degree of each person are different,the early occurrence may be a few months to 1 year after operation,and more patients are more obvious at about 2 years after operation.The rapid decline of VA caused by PCO seriously affects the surgical experience and postoperative quality of life of patients.The purpose of this study was to compare the difference of PCO between hydrophobic acrylate IOL and hydrophilic acrylate IOL within 1 year and 2 years after implantation,and to provide reference for selecting IOL for people with high incidence of PCO in clinical practice.Methods:All relevant literatures that can be searched on China knowledge Network database CNKI,Wanfang database Wan Fang,VIP database VIP,CBM,Medline,Pub Med,Embase,Clinical Key and Cochrane Library from the establishment of the database to December 2020 were searched by computer,and all randomized controlled trials of posterior capsular opacification after phacoemulsification combin-ed with hydrophobic acrylate IOL implantation and hydrophilic acrylate IOL implantation in all studies were collected.After the two evaluators selected the research,extracted data and quality evaluation according to the inclusion criteria and exclusion criteria,the Rev Man5.3 software was used for Meta analysis.The effect of measurement data was measured by standardized mean difference(SMD)and 95%confidence interval(CI),and the degree of postoperative PCO(posterior capsular opacification score)was combined and analyzed.The ratio ratio(OR)was used to measure the effect of counting data,and the postoperative Nd:YAG laser capsulotomy rate was combined and analyzed.Results:A total of 10 studies were included,involving a total of 743 eyes(369 eyes in the Hydrophobic group and 374 eyes in the Hydrophilic group).The results of the meta-analysis showed that at 1-year follow-up,hydrophobic acrylate IOL had a lower posterior capsule opacification score than hydrophilic acrylate IOL(SMD= 0.43,95%CI=0.23～0.64,Z=4.09,P<0.00001).At 2 years follow-up,hydrophobic acrylate IOL had a lower posterior capsule opacification score than hydrophilic acrylate IOL,And the difference is more significant.(SMD=0.67,95%CI=0.49～0.86,Z=7.12,P<0.00001).The Nd: YAG laser capsule incision rate of hydrophobic acrylate IOL was lower than that of hydrophilic acrylate IOL(OR=8.95,95%CI=4.70～17.04,Z=6.67,P<0.00001).Conclusion:Hydrophobic acrylate IOL is superior to hydrophilic acrylate IOL in reducing posterior capsule opacification and Nd:YAG laser capsulotomy.