title: Femtosecond laser versus mechanical microkeratome laser in situ keratomileusis for myopia: Metaanalysis of randomized controlled trials.
abstract: OBJECTIVE
  To examine differences in efficacy, accuracy, safety, and changes in aberrations between femtosecond and mechanical microkeratome laser in situ keratomileusis (LASIK) for myopia.
  
  
  METHODS
  Department of Ophthalmology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
  
  
  METHODS
  Evidence-based manuscript.
  
  
  METHODS
  Data sources, including PubMed, Medline, EMBASE, and Cochrane Controlled Trials Register, were searched to identify potentially relevant prospective randomized controlled trials. Primary outcome measures were efficacy (uncorrected distance visual acuity ≥20/20), accuracy (±0.50 diopter mean spherical equivalent), and safety (loss of ≥2 lines of corrected distance visual acuity). Aberrations and postoperative complications were secondary outcomes.
  
  
  RESULTS
  Seven prospective randomized controlled trials describing a total of 577 eyes with myopia were included in this metaanalysis. At 6 months or more follow-up, no significant differences were found in the efficacy (odds ratio [OR], 1.17; 95% confidence interval [CI], 0.40 to 3.42; P=.78), accuracy (OR, 1.69; 95% CI, 0.68 to 4.20; P=.26), or safety (OR, 7.37; 95% CI, 0.37 to 147.61; P=.19). In eyes that had femtosecond LASIK, the postoperative total aberrations (mean difference -0.03 μm; 95% CI, -0.05 to -0.01; P=.002) and spherical aberrations (mean difference -0.02 μm; 95% CI, -0.03 to -0.01; P<.00001) were significantly lower.
  
  
  CONCLUSIONS
  According to the metaanalysis, femtosecond LASIK did not have an advantage in efficacy, accuracy, and safety measures over mechanical microkeratome LASIK in the early and midterm follow-up, although it might induce fewer aberrations.
authors: Department of Ophthalmology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
authors: Zhi-Hua
authors: ZH
authors: Zhang
authors: Hui-Yi
authors: HY
authors: Jin
authors: Yan
authors: Y
authors: Suo
authors: Sanjay V
authors: SV
authors: Patel
authors: Robert
authors: R
authors: Montés-Micó
authors: Edward E
authors: EE
authors: Manche
authors: Xun
authors: X
authors: Xu
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000517:prevention & control; D016208:Databases, Factual; D004869:Equipment Safety; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D012029:Refraction, Ocular / Q000502:physiology; D012042:Registries; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult