BACKGROUND Accurate measurement of intraocular pressure (IOP) after corneal refractive surgery is of great significance to clinic, and comparisons among various IOP measuring instruments are not rare, but there is a lack of unified analysis. Although Goldmann Applanation Tonometer (GAT) is currently the internationally recognized gold standard for IOP measurement, its results are severely affected by central corneal thickness (CCT). Ocular Response Analyzer (ORA) takes certain biomechanical properties of cornea into account and is supposed to be less dependent of CCT. In this study, we conducted the meta-analysis to systematically assess the differences and similarities of IOP values measured by ORA and GAT in patients after corneal refractive surgery from the perspective of evidence-based medicine. METHODS The authors searched electronic databases (MEDLINE, EMBASE, Web of science, Cochrane library and Chinese electronic databases of CNKI and Wanfang) from Jan. 2005 to Jan. 2019, studies describing IOP comparisons measured by GAT and ORA after corneal refractive surgery were included. Quality assessment, subgroup analysis, meta-regression analysis and publication bias analysis were applied in succession. RESULTS Among the 273 literatures initially retrieved, 8 literatures (13 groups of data) with a total of 724 eyes were included in the meta-analysis, and all of which were English literatures. In the pooled analysis, the weighted mean difference (WMD) between IOPcc and IOPGAT was 2.67 mmHg (95% CI: 2.20~3.14 mmHg, p < 0.0001), the WMD between IOPg and IOPGAT was - 0.27 mmHg (95% CI: - 0.70~0.16 mmHg, p = 0.2174). In the subgroup analysis of postoperative IOPcc and IOPGAT, the heterogeneity among the data on surgical procedure was zero, while the heterogeneity of other subgroups was still more than 50%. The comparison of the mean difference of pre- and post-operative IOP (∆IOP) was: mean-∆IOPg > mean-∆IOPGAT > mean-∆IOPcc. CONCLUSIONS IOPcc, which is less dependent on CCT, may be more close to the true IOP after corneal refractive surgery compared with IOPg and IOPGAT, and the recovery of IOPcc after corneal surface refractive surgery may be more stable than that after lamellar refractive surgery.

中文翻译：

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角膜屈光手术后通过眼反应分析仪和Goldmann压平眼压计测量的眼内压比较：系统评价和荟萃分析。

背景技术角膜屈光手术后眼内压（IOP）的准确测量对临床意义重大，各种眼压测量仪器之间的比较并不罕见，但缺乏统一的分析方法。尽管戈德曼压平眼压计（GAT）目前是国际认可的用于眼压测量的金标准，但其结果受到中央角膜厚度（CCT）的严重影响。眼反应分析仪（ORA）考虑到了角膜的某些生物力学特性，因此对CCT的依赖性较小。在这项研究中，我们进行了荟萃分析，从循证医学的角度系统地评估了由ORA和GAT测量的角膜屈光手术后患者的IOP值的异同。方法作者检索了2005年1月至2019年1月的电子数据库（MEDLINE，EMBASE，Web of Science，Cochrane图书馆以及CNKI和Wanfang的中文电子数据库），包括描述角膜屈光手术后用GAT和ORA测量的IOP比较的研究。 。相继应用了质量评估，亚组分析，元回归分析和出版偏向分析。结果在最初检索的273篇文献中，荟萃分析包括8篇文献（13组数据），共724只眼，全部为英文文献。在合并分析中，IOPcc和IOPGAT之间的加权平均差（WMD）为2.67 mmHg（95％CI：2.20〜3.14 mmHg，p <0.0001），IOPg和IOPGAT之间的WMD为-0.27 mmHg（95％CI：- 0.70〜0.16 mmHg，p = 0.2174）。在术后IOPcc和IOPGAT的亚组分析中，外科手术数据之间的异质性为零，而其他亚组的异质性仍超过50％。术前和术后IOP的平均差（∆IOP）的比较为：均值-IOPg>均值-IOPGAT>均值-IOPcc。结论与COP相比，IOPcc较不依赖CCT，与IOPg和IOPGAT相比，角膜屈光手术后的IOPcc可能更接近真实IOP，并且角膜表面屈光手术后的IOPcc的恢复可能比层状屈光手术后的IOPcc更为稳定。均值-IOPg>均值-IOPGAT>均值-IOPcc。结论与COP相比，IOPcc较不依赖CCT，与IOPg和IOPGAT相比，角膜屈光手术后的IOPcc可能更接近真实IOP，并且角膜表面屈光手术后的IOPcc的恢复可能比层状屈光手术后的IOPcc更为稳定。均值-IOPg>均值-IOPGAT>均值-IOPcc。结论与COP相比，IOPcc较不依赖CCT，与IOPg和IOPGAT相比，角膜屈光手术后的IOPcc可能更接近真实IOP，并且角膜表面屈光手术后的IOPcc的恢复可能比层状屈光手术后的IOPcc更为稳定。