目的：系统评价577nm阈值下微脉冲激光与传统激光治疗糖尿病性黄斑水肿(DME)疗效差异性。

方法：计算机检索PubMed、Embase、Cochrane图书馆、Web of Science、CBM、 CNKI、CQVIP、CECDB数据库内的相关前瞻性或回顾性临床对照试验，检索时限均为从建库起截止2019-08。由两位研究者独立筛选文献、提取资料、评价文献质量，采用RevMan5.3/Stata 14.0软件对纳入研究进行meta分析。

结果：纳入7项研究，其中随机对照试验(RCT)6 项，回顾性临床对照研究(CCT)1项，共401例患者545眼。Meta分析结果显示：577nm阈值下微脉冲激光组BCVA的测量值高于传统激光组 \〖95%CI(0.02～0.08)，P=0.002\〗，577nm阈值下微脉冲激光组的黄斑中心视网膜厚度测量值较传统激光组明显减少[95% CI(-26.96～-10.88)，P<0.00001]，577nm阈值下微脉冲激光组黄斑10°范围内视网膜平均光敏感度水平的测量值较传统激光组明显提升[95% CI(1.56～2.39)，P<0.00001]。

结论：577nm阈值下微脉冲激光能更好地改善DME患者的视功能，且具有较高的治疗安全性，对于患者的治疗具有较好的研究价值。

METHODS:Retrieved from PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, CQVIP, and CECDB databases, randomized controlled trials(RCT)and retrospective clinical control trials(CCT)about the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema were collected. The search time was from the establishment of the library until August 2019. Meta-analysis was performed by using RevMan 5.3/Stata 14.0 software after screening the literature, extracting the data, and evaluating the quality of the literature by two researchers.

RESULTS: A total of 7 studies, 6 RCTs and 1 CCT involving 401 patients and 545 eyes were included. The results of Meta-analysis showed that the best corrected visual acuity(BCVA)measured values in the 577nm subthreshold micropulse diode laser group were higher than the conventional laser group \〖95% CI(0.02, 0.08), P=0.002\〗. The macular retinal thicken measured values in the 577nm subthreshold micropulse diode laser group was significantly lower the conventional laser group \〖95% CI(-26.96 to -10.88), P<0.00001\〗. The mean sensitivity within macular 10° examination measured values in the 577nm subthreshold micropulse diode laser group was significantly higher than that conventional laser group \〖95% CI(1.56 to 2.39), P<0.00001\〗.

CONCLUSION: 577nm subthreshold micropulse diode laser can not only better improve the visual function of patients with DME, but also have a higher safety in treatment. 577nm subthreshold micropulse diode laser has good research value for the treatment of DME, it's worthy of application and promotion in clinical practice.