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The effect of hinge location on corneal sensation and dry eye after LASIK: a systematic review and meta-analysis
作者:冯一帆  文章来源:温州医学院附属眼视光医院  点击数183  更新时间:2012/9/13  文章录入:毛进  责任编辑:毛进

Background: Dry eye syndrome is a frequent postoperative complication of laser in situ keratomileusis (LASIK). Some studies reported the hinge location of corneal flap does some effects on the dry eye syndrome after LASIK. This systematic review was to evaluate and compare the effects of a superior and nasal/temporal-hinge location on dry eye syndrome after LASIK.   
Methods: A systematic literature retrieval was conducted in the MEDLINE, EMBASE, Cochrane Library and CNKI from 1990 to 2011. The outcome parameters included tear film breakup time (BUT), Schirmer’s I test and corneal sensation at 1 week, 3 and 6~12 months postoperatively. The statistical analysis was performed using a RevMan 5.0 software and the quality of included literatures were scored according to the Jadad scale.  
Results: A total of 7 randomized control trials involving 331 patients (652 eyes) were included in the meta-analysis. BUT in eyes with superior-hinge group was obvious shorter than that of nasal/temporal-hinge group at 1 week (WMD=0.42, 95%CI: -0.79 to -0.06P = 0.02), but there was no difference in 3 and 6~12 months postoperatively. Better corneal sensation was found at 3 month (WMD =0.62, 95%CI: -1.09 to -0.19P = 0.005) in the nasal/temporal-hinge group, but there was no difference in 1 week and 6~12 months postoperatively. No significant difference between the two groups was found for the amount of Schirmer’s I test at all postoperative visits.   
Conclusion: LASIK with nasal/temporal-hinge corneal flap has some effects on corneal sensation and the dry eye syndrome after LASIK. More high-quality studies are need for the further clinical evaluation.

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