目的：系统评价经角膜地形图引导与波前像差优化的FS-LASIK术后屈光度与高阶像差的增幅。

方法：检索PubMed、the Cochrane Library、Medline、CNKI、CBM、VIP和WanFang Data数据库中的RCT与CT研究，语言限定为中文或英文，语言限定为中文或英文。对纳入的RCT与CT文献分别采用《Cochrane干预措施系统评价手册》中偏倚风险评价工具与《NOS量表》进行质量评价； 对纳入文献的发表偏倚采用Egger检验进行检测； 采用Review Manager 5.4软件进行Meta分析。

结果：共有8篇文献符合纳入和排除标准，包含987例研究对象(角膜地形图引导组482例，波前像差优化组505例)。Meta分析结果显示：地形图引导组术后等效屈光度高于波前优化组\〖WMD=0.11，95%CI(0.07，0.14)，P<0.00001\〗； 与波前优化组相比，地形图引导组术后能够获得更低的HOAs\〖WMD=-0.09，95%CI(-0.13，-0.05)，P<0.0001\〗、球差\〖WMD=-0.05，95%CI(-0.09，-0.01)，P=0.008\〗、彗差\〖WMD=-0.08，95%CI(-0.12，-0.05)，P<0.00001\〗增幅。

结论：经角膜地形图引导的FS-LASIK手术方式能使患者获得更高的屈光度，并有效降低术后HOAs、球差、彗差增幅。

METHODS: We searched on PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs)and comparative studies(CTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by the Egger test. Meta-analysis was performed with Review Manager 5.4.

RESULTS: Two randomized controlled trials and six comparative studies with a total of 987 subjects were included(482 in the topography-guided FS-LASIK group, 505 in the wavefront optimized FS-LASIK group). The Meta-analysis showed that the topography-guided group has a better effect than the wavefront-optimized group in spherical equivalent, the difference between the two groups was statistically significant \〖WMD=0.11, 95%CI (0.07, 0.14), P<0.00001\〗. And the results also indicated that there was a significant difference between the two groups with HOAs \〖WMD= -0.09, 95%CI (-0.13,-0.05), P<0.0001\〗, spherical aberrations \〖WMD=-0.05, 95%CI (-0.09, -0.01), P=0.008\〗 and coma \〖WMD=-0.08, 95%CI (-0.12, -0.05), P<0.00001\〗.

CONCLUSION: Based on the available evidence, topography-guided FS-LASIK has higher diopter and lower HOAs, spherical aberrations and coma than wavefront-optimized FS-LASIK.