Compliance with orthokeratology lens wear: a systematic review and meta-analysis.

Effectiveness of Laser Therapy in Stress Urinary Incontinence Patients: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of laser therapy in improving urinary and sexual function in women with SUI.Methods: The literature was selected using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. We did literature searches in several databases, including Science Direct, Pubmed, Google Scholar, Cochrane, ProQuest, and Scopus, from inception until January 2025. Quality assessment was performed using the Cochrane Risk of Bias Tool. Mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model.Result: There were ten journals with 598 participants that met the criteria. The results of the pooled analysis showed a statistically significant improvement in post-laser therapy pad weight (MD = -0.49; 95% CI: -0.97 to -0.01; p = 0.0435). Despite the non-significant differences and heterogeneity found in the meta-analysis of sexual function outcome (MD = -0.49; 95% CI: -0.97 to -0.01; p = 0.0435), the individual studies stated that the sexual function was improved in women with SUI post-laser therapy.Discussion: Laser therapy, particularly CO₂ and Er:YAG modalities, appears effective in enhancing sexual function in women with SUI. Variability in protocols and outcome measures among studies may contribute towards heterogeneity. Most trials had small sample sizes and short follow-ups.Conclusion: Laser therapy shows promise for improving urinary and sexual function in women with SUI, warranting further robust research.Efektivitas Terapi Laser pada Pasien Inkontinensia Urin Stres: Tinjauan Sistematis dan Meta-AnalisisAbstrakTujuan: Tinjauan sistematis dan meta-analisis ini bertujuan untuk mengevaluasi efektivitas terapi laser dalam meningkatkan fungsi urinasi dan seksual pada wanita dengan SUI.Metode: Literatur diseleksi dengan protokol Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Penelusuran literatur dilakukan pada beberapa basis data, termasuk Science Direct, Pubmed, Google Scholar, Cochrane, ProQuest, dan Scopus, sejak awal hingga Januari 2025. Penilaian kualitas dilakukan menggunakan Cochrane Risk of Bias Tool. Perbedaan mean (MD) dengan interval kepercayaan (CI) 95% dihitung menggunakan model efek acak.Hasil: Terdapat sepuluh jurnal dengan 598 partisipan yang memenuhi kriteria. Hasil penelitian dari analisis gabungan menunjukan bahwa terdapat peningkatan yang signifikan secara statistik pada pad weight pasca terapi laser (MD = -0,49; 95% CI: -0,97 hingga -0,01; p = 0,0435). Meskipun perbedaan dan heterogenitas yang tidak signifikan ditemukan dalam meta-analisis hasil fungsi seksual (MD = -0.49; 95% CI: -0.97 to -0.01; p = 0.0435), studi individual menyatakan bahwa fungsi seksual membaik pada wanita dengan SUI pasca-terapi laser.Diskusi: Terapi laser, khususnya modalitas CO₂ dan Er:YAG, tampak efektif dalam meningkatkan fungsi seksual pada wanita dengan SUI. Variabilitas dalam protokol dan ukuran hasil di antara studi dapat berpengaruh pada heterogenitas. Sebagian besar uji coba memiliki ukuran sampel kecil dan follow-up yang singkat.Kesimpulan: Terapi laser menunjukkan harapan untuk meningkatkan fungsi urin dan seksual pada wanita dengan SUI, yang menjamin penelitian lebih lanjut yang kuat.

Factors and Reasons Influencing Compliance with Post-vasectomy Semen Analysis: A Systematic Review.

Efficacy of Orthokeratology in Controlling Axial Elongation in Myopic Children and Adolescents: A Systematic Review and Meta-Analysis of Comparative Interventions

Background: Myopia represents a growing global public health concern, with prevalence projected to reach 4.9 billion people by 2050. Orthokeratology has emerged as a non-invasive optical intervention for myopia control in children. This systematic review and meta-analysis evaluated the efficacy of orthokeratology in reducing axial length (AL) growth compared to spectacles, atropine combinations, multifocal contact lenses, gradient soft contact lenses, modified orthokeratology with enhanced peripheral defocus (enhanced OK), and atropine therapy with single-vision spectacle correction. Methods: A systematic literature search was conducted in PubMed and Google Scholar for studies published in the past 20 years (2004–2024) using keywords “orthokeratology” OR “corneal reshaping” AND “myopia control.” Inclusion criteria comprised longitudinal clinical studies (randomized or non-randomized) with AL measurements, at least two groups including orthokeratology, and publication in English or Portuguese. Meta-analysis was performed using Review Manager 5.0.25 with random-effects models. Heterogeneity was assessed using I2 statistics, and subgroup analyses were conducted by follow-up duration. Results: Thirty-one studies met inclusion criteria. Orthokeratology significantly reduced AL growth compared to spectacles (25 studies, 4267 patients; mean difference [MD] = −0.16 mm, 95% CI −0.19 to −0.14, p < 0.00001, I2 = 97%). Combined orthokeratology with atropine showed superior efficacy to orthokeratology alone (8 studies, 888 patients; MD = 0.09 mm, 95% CI 0.06 to 0.12, p < 0.00001, I2 = 98%). Orthokeratology demonstrated equivalent efficacy to multifocal contact lenses (3 studies, 208 patients; MD = 0.00 mm, 95% CI −0.04 to 0.05, p = 0.85, I2 = 83%). Atropine therapy with single-vision spectacle correction and enhanced OK showed superior myopia control compared to conventional orthokeratology. Conclusions: Orthokeratology effectively slows axial elongation in myopic children compared to spectacles, with efficacy comparable to multifocal contact lenses. Combination therapies, particularly orthokeratology with atropine, demonstrate additive benefits. High heterogeneity across studies highlights the need for standardized protocols and long-term follow-up studies to optimize myopia control strategies.

Risk factors for late intraocular lens dislocation: a systematic review and meta-analysis.

TOPIC To quantify associations between potential risk factors and late intraocular lens (IOL) dislocation after uncomplicated phacoemulsification with IOL implantation. CLINICAL RELEVANCE Late IOL dislocation is an uncommon but clinically important long-term complication of cataract surgery. Although several predisposing conditions have been described, their relative contribution has not been comprehensively quantified. METHODS A systematic review and meta-analysis were performed according to PRISMA. The study protocol was prospectively registered on PROSPERO (CRD420261328390). MEDLINE, Google Scholar, ScienceDirect, and Cochrane Library were searched for English- and Russian-language studies published from 2000 to 2025. Comparative observational studies were included in the meta-analysis; additional non-comparative studies were used for descriptive synthesis of prevalence data. Risk of bias was assessed with the Newcastle-Ottawa Scale. Random-effects models were used to pool odds ratio (OR) with 95% confidence interval (CI). RESULTS Eight comparative studies were included in the meta-analysis and 28 non-comparative studies in descriptive synthesis. The strongest associations were found for zonular weakness (OR 8.04, 95% CI 5.27-12.28), ocular trauma (OR 5.98, 95% CI 2.16-16.52), uveitis (OR 5.73, 95% CI 2.23-14.68), and pseudoexfoliation syndrome (OR 5.72, 95% CI 3.23-10.15). Myopia (OR 3.32, 95% CI 1.38-7.97) and glaucoma (OR 2.60, 95% CI 1.46-4.60) showed moderate associations, whereas previous vitrectomy and male sex were not statistically significant. CONCLUSIONS Late IOL dislocation is most strongly associated with structural and inflammatory damage to the capsular-zonular complex. High prevalence of a factor among cases does not necessarily indicate independent pathogenetic significance.

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Incidence and Risk Factors of Cochlear Implant Complications: A Systematic Review and Meta-Analysis

Objective: This review aimed to evaluate the existing literature to determine the incidence and associated risk factors of cochlear implant complications. Data Sources: A comprehensive literature search was conducted across PubMed, Web of Science, Embase, and Scopus up to 12 April 2025. Methods: The review protocol was registered on PROSPERO (ID: CRD420251012225) on 15 March 2025, and the systematic review was performed according to PRISMA guidelines. Results: We included a total of 100 records based on 81 studies with 42,167 patients. The overall incidence was 13.7%. Major complications occurred in 5.2%, with device failure being the most common at 2.8%. Minor complications affected 7.8%, with superficial wound infections being most frequent at 2.3%. Vestibular complications (vertigo/dizziness) were prevalent at 12.4%. Adults had significantly higher overall and major complication rates compared to pediatric patients. The mastoidectomy with posterior tympanotomy approach (MPTA) was associated with lower rates (5.4%) than the suprameatal approach (SMA) (7.8%). A significant temporal trend showed decreased complication rates from 8.9% in the early era (1991–2010) to 4.1% in the recent era (2011–2025). Significant risk factors were identified including older age at implantation, inner ear malformations, chronic otitis media, previous otologic surgery, and longer surgery duration. A substantial heterogeneity was present across the included studies (I2 up to 93.6%), and the evidence base was predominantly retrospective in nature, which limits the certainty of these estimates. Conclusions: Cochlear implantation appears to be a generally safe procedure. However, these findings should be interpreted with caution. The high heterogeneity, predominantly retrospective study designs, inconsistent complication definitions, and detected publication bias collectively limit the certainty of the pooled estimates. Standardized complication reporting, prospective multicenter designs, and consensus-based outcome definitions are essential to strengthen the evidence base and guide safer clinical practice.