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.