Systematic review and Meta-analysis comparing modified cross-linking and standard cross-linking for progressive keratoconus

作     者：Yang Liu Yi Liu Ying-Nan Zhang Ai-Peng Li Jing Zhang Qing-Feng Liang Ying Jie Zhi-Qiang Pan 

作者机构：Beijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical UniversityBeijing Ophthalmology and Visual Sciences Key LaboratoryBeijing 100005China Department of OphthalmologyFirst Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Beijing Institute of OphthalmologyBeijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical University Beijing Ophthalmology and Visual Sciences Key LaboratoryBeijing 100005China 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2017年第10卷第9期

页      面：1419-1429页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：progressive keratoconus cross-linking standardcross-linking accelerated cross-linking trans-epithelial cross-linking Meta-analysis 

摘      要：AIM：To compare the effectiveness and safety between modified cross-linking（MC）and standard cross-linking（SC）in mild or moderate progressive ***：Eligible studies were retrieved from four electronic databases,including CENTRAL,Clinical Trials gov,Pup Med and OVID *** set post-surgical maximum K value（Kmax）as the primary *** addition,uncorrected and corrected distant visual acuity（UDVA and UDVA）,spherical equivalent（SE）,endothelial cell density（ECD）,central cornea thickness（CCT）and depth of demarcation line（DDL）were Meta-analyzed as secondary *** differences for these outcomes were pooled through either a random-effect model or fixed-effect model according to data ***：Twenty-four comparative studies either on accelerated cross-linking（AC）compared with SC or on transepithelial cross-linking（TC）compared with SC were included and pooled for *** results indicated that MC was significantly inferior to SC at delaying Kmax deterioration[AC vs SC 0.49（95%CI：0.04-0.94,I2=75%,P=0.03）;TC vs SC 1.15（95%CI：0.54-1.75,I2=50%,P=0.0002）].SE decreased significantly for SC when compared to AC[0.62（95%CI：0.38-0.86,I2=22%,P〈0.00001）].DDL of SC was more significantly deeper than that of TC[-133.49（95%CI：-145.94 to-121.04,I2=33%,P〈0.00001）].Other outcomes demonstrated comparable results between MC and ***：SC is more favorable at halting the progression of keratoconus,but visual acuity improvement showed comparable results between MCs and SC.