PURPOSE To evaluate the differences in efficacy, predictability, safety, and visual quality between topography-guided customized ablation treatment (TCAT) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) for the treatment of myopia with and without astigmatism. METHODS A comprehensive literature search of PubMed, Embase, the Cochrane library, Web of Science, and ClinicalTrials was used to identify randomized controlled trials (RCTs) comparing TCAT-LASIK with WFO-LASIK for myopia with and without astigmatism up to September 2020. The references of all searched literature were checked as supplements. Literature was screened according to the inclusion and exclusion criteria and relative data were extracted. RevMan software version 5.3.0 (Cochrane Collaboration) was used for meta-analysis. RESULTS A total of seven RCTs (1,168 eyes) were included. There were no statistically significant differences in the ratio of uncorrected distance visual acuity of 20/20 or better (relative risk [RR] = 1.01, 95% CI [0.97 to 1.06], P = .64) and 20/16 or better (RR = 0.96, 95% CI [0.80 to 1.16], P = .69). Compared with WFO-LASIK, TCAT-LASIK achieved a higher proportion of postoperative manifest refractive spherical equivalent within ±0.50 diopters of the target (RR = 1.06, 95% CI [1.02 to 1.11], P = .003) and less surgically induced higher order aberrations (weighted mean difference [WMD] = -0.11, 95% CI [-0.15 to -0.0], P < .00001), spherical aberrations (WMD = -0.04, 95% CI [-0.05 to -0.03], P < .00001), and coma (WMD = -0.15, 95% CI [-0.28 to -0.01], P = .03). No patient lost two or more lines of distance-corrected visual acuity postoperatively in the two groups. CONCLUSIONS This meta-analysis suggests that both TCATLASIK and WFO-LASIK show excellent efficacy, predictability, and safety for myopia. TCAT-LASIK exhibited more accurate postoperative refraction predictability and less surgically induced higher order aberrations, spherical aberrations, and coma. More randomized, prospective, and large sample-sized studies are needed to confirm these conclusions in the long term. [J Refract Surg. 2021;37(10):707-714.].

中文翻译：

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地形引导与波前优化 LASIK 治疗近视和无散光：一项荟萃分析。

目的 评估地形引导的定制消融治疗 (TCAT) 和波前优化 (WFO) 激光原位角膜磨镶术 (LASIK) 治疗有和无散光的近视在疗效、可预测性、安全性和视觉质量方面的差异。方法 使用对 PubMed、Embase、Cochrane 图书馆、Web of Science 和 ClinicalTrials 的综合文献检索来确定截至 2020 年 9 月比较 TCAT-LASIK 和 WFO-LASIK 治疗散光近视的随机对照试验 (RCT)。检查所有检索文献的参考文献作为补充。根据纳入和排除标准筛选文献，提取相关资料。RevMan 软件版本 5.3.0（Cochrane Collaboration）用于荟萃分析。结果 共有 7 个 RCT（1，168 只眼睛）。未矫正远视力为 20/20 或更高（相对风险 [RR] = 1.01，95% CI [0.97 至 1.06]，P = .64）和 20/16 或更高（ RR = 0.96，95% CI [0.80 至 1.16]，P = .69）。与 WFO-LASIK 相比，TCAT-LASIK 在目标的 ±0.50 屈光度范围内实现了更高比例的术后明显屈光球面等效（RR = 1.06，95% CI [1.02 至 1.11]，P = .003）并且更少的手术诱导更高顺序像差（加权平均差 [WMD] = -0.11，95% CI [-0.15 至 -0.0]，P < .00001），球面像差（WMD = -0.04，95% CI [-0.05 至 -0.03]，P < .00001) 和昏迷（WMD = -0.15，95% CI [-0.28 至 -0.01]，P = .03）。两组患者术后均无两线以上远距矫正视力下降。结论 这项荟萃分析表明，TCATLASIK 和 WFO-LASIK 均显示出对近视的出色疗效、可预测性和安全性。TCAT-LASIK 显示出更准确的术后屈光预测性和更少的手术引起的高阶像差、球面像差和彗差。从长远来看，需要更多的随机、前瞻性和大样本研究来证实这些结论。[J 屈光手术。2021;37(10):707-714.]。需要大样本研究来长期证实这些结论。[J 屈光手术。2021;37(10):707-714.]。需要大样本研究来长期证实这些结论。[J 屈光手术。2021;37(10):707-714.]。