Meta-analysis of two kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification

AIM: To systematically evaluate the efficacy and safety of two different kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification after cataract surgery and provide reliable evidence for the selection of posterior capsulotomy in clinical practice.METHODS: A literature search was implemented in CNKI, Wanfang database, VIP database, PubMed, Medline and Cochrane Library from 2000-01-01 to 2019-12-31. Two researchers independently performed literature search, screening, quality evaluation, and data extraction. Meta-analysis was performed by RevMan 5.3 software. The mean difference and 95% confidence interval were used to measure the measurement data, including best corrected visual acuity, postoperative intraocular pressure, and laser energy. The odds ratio was used to measure the count data, including the rate of lens damage and the incidence of vitreous floaters.RESULTS: A total of 7 studies were included, including Nd:YAG laser circular posterior capsulotomy and cruciate posterior capsulotomy in 432 eyes. The Meta-analysis showed that there was no significant difference in postoperative best corrected visual acuity between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, MD=-0.01(95% CI: -0.03-0.01, P=0.32); there was no significant difference in postoperative IOP between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, MD=-0.60(95% CI: -1.31-0.11, P=0.10); there was no significant difference in laser energy between the two groups, MD=18.82(95% CI: -11.88-49.51, P=0.23); there was also no significant difference in the rate of lens damage and the incidence of vitreous floaters, OR=0.97(95% CI: 0.50-1.87, P=0.93); OR=2.88(95% CI: 0.28-29.26, P=0.37). CONCLUSION:In the treatment of posterior capsular opacification after cataract surgery with Nd:YAG laser posterior capsulotomy, there is no significant difference in efficacy and safety between circular posterior capsulotomy and cruciate posterior capsulotomy.