Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis
BackgroundPhacoemulsification is an effective and widely performed technique in cataract surgery, but the comparative anatomical outcomes, including endothelial cell loss (ECL), central corneal thickness (CCT), and central macular thickness (CMT), between high-flow and low-flow phacoemulsification c...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1021941/full |
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| author | Po-Chin Kuo Jia-Horung Hung Jia-Horung Hung Yu-Chen Su Ching-Ju Fang Ching-Ju Fang Chaw-Ning Lee Chaw-Ning Lee Yi-Hsun Huang Shih-Chieh Shao Shih-Chieh Shao Edward Chia-Cheng Lai |
| author_facet | Po-Chin Kuo Jia-Horung Hung Jia-Horung Hung Yu-Chen Su Ching-Ju Fang Ching-Ju Fang Chaw-Ning Lee Chaw-Ning Lee Yi-Hsun Huang Shih-Chieh Shao Shih-Chieh Shao Edward Chia-Cheng Lai |
| author_sort | Po-Chin Kuo |
| collection | DOAJ |
| description | BackgroundPhacoemulsification is an effective and widely performed technique in cataract surgery, but the comparative anatomical outcomes, including endothelial cell loss (ECL), central corneal thickness (CCT), and central macular thickness (CMT), between high-flow and low-flow phacoemulsification cataract surgery remain unclear.MethodsThis study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Random-effects models were applied to measure pooled mean differences (MD) with 95% confidence intervals (CI) of anatomical outcomes between high-flow and low-flow phacoemulsification cataract surgery. We judged overall certainty of evidence (CoE) based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.ResultsWe included six randomized controlled trials (RCTs) totaling 477 participants. The meta-analysis showed similar changes associated with these two surgery types in both ECL at postoperative days 2–14 (MD: −1.63%; 95% CI: −3.73 to 0.47%; CoE: very low), days 15–42 (MD: −0.65%; 95% CI −2.96 to 1.65%; CoE: very low) and day 43 to month 18 (MD: −0.35%; 95% CI: −1.48 to 0.78%; CoE: very low), and CCT at postoperative day 1 (MD: −16.37 μm; 95% CI: −56.91 to 24.17 μm; CoE: very low), days 2–14 (MD: −10.92 μm; 95% CI: −30.00 to 8.16 μm; CoE: very low) and days 15–42 (MD: −2.76 μm; 95% CI: −5.75 to 0.24 μm; CoE: low). By contrast, low-flow phacoemulsification showed less increase in CMT at postoperative days 15–42 (MD, −4.58 μm; 95% CI: −6.3 to −2.86 μm; CoE: low).ConclusionsWe found similar anatomical outcomes, except in CMT, for both high-flow and low-flow phacoemulsification cataract surgery. Future head-to-head RCTs on visual outcomes should confirm our findings.Systematic review registrationPROSPERO, identifier: CRD42022297036. |
| first_indexed | 2024-12-10T05:57:29Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-10T05:57:29Z |
| publishDate | 2022-09-01 |
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| spelling | doaj.art-224689a7a20e48dab269f4c424062fc72022-12-22T01:59:53ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-09-01910.3389/fmed.2022.10219411021941Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysisPo-Chin Kuo0Jia-Horung Hung1Jia-Horung Hung2Yu-Chen Su3Ching-Ju Fang4Ching-Ju Fang5Chaw-Ning Lee6Chaw-Ning Lee7Yi-Hsun Huang8Shih-Chieh Shao9Shih-Chieh Shao10Edward Chia-Cheng Lai11Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanMedical Library, National Cheng Kung University, Tainan, TaiwanDepartment of Secretariat, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, TaiwanSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanBackgroundPhacoemulsification is an effective and widely performed technique in cataract surgery, but the comparative anatomical outcomes, including endothelial cell loss (ECL), central corneal thickness (CCT), and central macular thickness (CMT), between high-flow and low-flow phacoemulsification cataract surgery remain unclear.MethodsThis study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Random-effects models were applied to measure pooled mean differences (MD) with 95% confidence intervals (CI) of anatomical outcomes between high-flow and low-flow phacoemulsification cataract surgery. We judged overall certainty of evidence (CoE) based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.ResultsWe included six randomized controlled trials (RCTs) totaling 477 participants. The meta-analysis showed similar changes associated with these two surgery types in both ECL at postoperative days 2–14 (MD: −1.63%; 95% CI: −3.73 to 0.47%; CoE: very low), days 15–42 (MD: −0.65%; 95% CI −2.96 to 1.65%; CoE: very low) and day 43 to month 18 (MD: −0.35%; 95% CI: −1.48 to 0.78%; CoE: very low), and CCT at postoperative day 1 (MD: −16.37 μm; 95% CI: −56.91 to 24.17 μm; CoE: very low), days 2–14 (MD: −10.92 μm; 95% CI: −30.00 to 8.16 μm; CoE: very low) and days 15–42 (MD: −2.76 μm; 95% CI: −5.75 to 0.24 μm; CoE: low). By contrast, low-flow phacoemulsification showed less increase in CMT at postoperative days 15–42 (MD, −4.58 μm; 95% CI: −6.3 to −2.86 μm; CoE: low).ConclusionsWe found similar anatomical outcomes, except in CMT, for both high-flow and low-flow phacoemulsification cataract surgery. Future head-to-head RCTs on visual outcomes should confirm our findings.Systematic review registrationPROSPERO, identifier: CRD42022297036.https://www.frontiersin.org/articles/10.3389/fmed.2022.1021941/fullphacoemulsificationcataract surgeryfluidicsendothelial cell losscentral corneal thicknesscentral macular thickness |
| spellingShingle | Po-Chin Kuo Jia-Horung Hung Jia-Horung Hung Yu-Chen Su Ching-Ju Fang Ching-Ju Fang Chaw-Ning Lee Chaw-Ning Lee Yi-Hsun Huang Shih-Chieh Shao Shih-Chieh Shao Edward Chia-Cheng Lai Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis Frontiers in Medicine phacoemulsification cataract surgery fluidics endothelial cell loss central corneal thickness central macular thickness |
| title | Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis |
| title_full | Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis |
| title_fullStr | Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis |
| title_full_unstemmed | Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis |
| title_short | Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis |
| title_sort | comparative anatomical outcomes of high flow vs low flow phacoemulsification cataract surgery a systematic review and meta analysis |
| topic | phacoemulsification cataract surgery fluidics endothelial cell loss central corneal thickness central macular thickness |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1021941/full |
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