Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis

OBJECTIVE: To systematically evaluate the efficacy, safety, recovery speed, and long-term visual quality of excimer laser corneal refractive surgery and to provide evidence-based medicine for the promotion and use of excimer laser corneal refractive surgery. METHODS: Randomized controls on excimer laser refractive surgery in Web of science, PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network (CNKI), China VIP Database, Wan Fang Database, and China Biomedical Literature Database (CBM) were searched by the computer. Randomized controlled trial (RCT) data were extracted independently by two researchers, and the risk of bias of each included RCT was assessed according to the Cochrane Handbook 5.1.0 criteria. Meta-analysis of the collected data was performed using RevMan5.4 statistical software. RESULTS: In the end, 9 high-quality literatures were included, with a total of 4366 samples, and meta-analysis was used. There was no significant difference in uncorrected visual acuity WMD after excimer laser keratorefractive surgery, but there was a statistically significant difference in WMD in the safety of excimer laser keratorefractive surgery. The results of uncorrected visual acuity (close) indicated the following: Chi(2) = 13.56, DF = 5, P = 0.02, and I(2) = 100%; the results of uncorrected visual acuity (distance) indicated the following: Chi(2) = 34.44, DF =5 (P < 00000), and I(2) = 85%; the results of best corrected visual acuity (myopia) indicated the following: Chi(2) = 0.65, DF = 3, P = 088 > 0.05, and I(2) = 0%; the results of best corrected visual acuity (hyperopia) indicated the following: Chi(2) = 1.80, DF = 3, P = 0.61 > 0.05, and I(2) = 0%. CONCLUSION: Excimer laser corneal refractive surgery is safe and effective, with faster recovery and better long-term visual acuity treatment effect. However, more studies and follow-up with higher methodological quality and longer intervention time are needed for further validation.