Objective To evaluate the clinical effectiveness of different surgical treatments for recurrent pterygium. Methods Databases such as The Cochrane Library, PubMed (1966 to 2011), EMbase (1989 to 2011), CNKI (1979 to 2011), VIP (1989 to 2011) and WanFang Data (1982 to 2011) were electronically searched for randomized controlled trials (RCTs) on different surgical treatments for recurrent pterygium, and the relevant references were also retrieved. According to the inclusion criteria, we screened literature, extracted data, and critically assessed the quality of RCTs. Then the meta-analysis was conducted using RevMan 5.0 software. Results A total of 19 RCTs were included. The results of meta-analyses showed, limbal stem cell autograft transplantation (LAT) combined with amniotic membrane transplantation (AMT), LAT alone, and intraoperative using of mitomycin C, effectively reduced the recurrence rate of recurrent pterygium. Statistic differences were found (Plt;0.01) when they were compared with conventional pterygium excision alone or plus AMT. Conclusion Current evidence shows LAT+AMT, LAT alone, and intraoperative using of mitomycin C can effectively reduce the recurrence rate of recurrent pterygium. But this conclusion still needs to be proved by large-scale RCTs due to the limited quantity and quality of the included studies.
Objectives To assess the clinical effectiveness of laser in situ keratomileusis (LASIK) versus laser epithelial keratomileusis (LASEK) for the correction of myopia. Methods Randomised controlled trials (RCTs) were searched in PubMed, EMbase, The Cochrane Library (Issue 2, 2010), CNKI, VIP, and WangFang Data from January, 1990 to October, 2010. The RCTs were included in accordance with the Cochrane review’s methodology, the valid data were extracted, the quality was evaluated, and then the RevMan 5.0 software was used for statistical analyses. Results Seven RCTs involving 1 134 eyes with myopia were included. The results of meta-analyses showed that the efficacy (OR=1.23, 95%CI 0.73 to 2.07), accuracy (OR=1.73, 95%CI 0.74 to 2.53) and safety (OR=1.10, 95%CI 0.22 to 5.59) outcomes between LASIK and LASEK were comparable. Compared with LASIK, LASEK was higher in the incidence rate of postoperative eye pain (RR=0.13, 95%CI 0.08 to 0.22). Conclusion LASIK and LASEK have the same effectiveness for myopia, but LASEK induces more postoperative eye pains. A large number of strictly-designed multi-centred RCTs are required for further verifying this result because of the low quality and instable results of the included studies．
Objective To evaluate the efficacy and safety of latanoprost versus travoprost for primary open-angle glaucoma (OAG) and ocular hypertension (OH). Methods All the randomized controlled trials (RCTs) about treating primary open-angle glaucoma and ocular hypertension with latanoprost and travoprost were collected by searching MEDLINE, EMbase, OVID and CNKI. The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers, and the meta-analysis was conducted with RevMan 5.0 software. Results A total of 13 RCTs involving 1 433 patients were included. The results of meta-analyses showed that, a) At the second week, travoprost showed greater intraocular pressure (IOP) lowering efficacy compared with latanoprost (WMD= –1.47, 95%CI –2.62 to –0.33). At the first month (WMD= –0.50, 95%CI –1.52 to 0.52) and the sixth month (WMD= –0.12, 95%CI –0.85 to 0.61), the difference of IOP reduction between latanoprost and travoprost group was not significant; and b) The latanoprost-treated group showed fewer reported conjunctival congestion than the travoprost-treated group (OR=0.47, 95%CI 0.35 to 0.63). The difference in adverse events of eye pain (OR=0.55, 95%CI 0.27 to 1.12) and iris or skin depigmentation (OR=1.25, 95%CI 0.53 to 2.92) between latanoprost and travoprost group was not significant. Conclusion Latanoprost and travoprost are comparable in lowering IOP for OAG and OH patients. Latanoprost shows greater ocular tolerability with lower incidence of side effects as conjunctival congestion. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, entirely and precisely evaluating the efficacy.
Objective Methods of evidence-based medicine were used to make an individualized treatment plan concerning newly diagnosed open-angle glaucoma patient. Methods After clinical problems were put forward, evidence was collected from Cochrane Library (Issue 4, 2009), PubMed (1990 -2009), MEDLINE (1990-2009), EMbase (1990-2009), CBM (1990-2009), and CNKI (1990-2009) according to the search strategy. Subject words were open-angle glaucoma, timolol, latanoprost, trabeculectomy, intraocular pressure, randomized controlled trials, human, meta-analysis, systematic review. Results A total of 221 randomized controlled trials, and 19 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data. After one year follow-up, the plan was proved optimal. Conclusion The treatment efficacy in newly diagnosed open-angle glaucoma has been improved by determining an individualized treatment plan according to evidence-based methods.