AI Article Synopsis
- The study evaluates the complication rates of various intraocular lens (IOL) placement methods in adults who lack adequate capsular bag support.
- It analyzes data from 15 studies involving 1,247 eyes, finding that iris fixation had a lower overall complication rate (4.4%) compared to anterior chamber (AC) placement (7.4%) and scleral fixation (7.4%).
- Common complications included transient corneal edema primarily in AC placement (29.9%) and higher rates of vitreous hemorrhages and IOL dislocation with scleral fixation.
Article Abstract
Topic: To evaluate the complication rates of different IOL placement methods in adults with inadequate capsular bag support.
Clinical Relevance: The surgical correction of inadequate capsular bag support for the intraocular lens (IOL) harbors several challenges, and there is a wide-range of surgical procedures.
Methods: For the purpose of this meta-analysis, surgical methods were grouped based on the location of IOL placement: (i) AC placement, (ii) iris fixation, which included prepupillary or retropupillary placement of an iris-claw IOL, or iris suturing of an IOL (iii) scleral fixation, which included scleral sutured and sutureless techniques. Only studies comparing the results of two or more different placement methods were analyzed. The study protocol has been registered in the PROSPERO database (CRD42023458557).
Results: Fifteen studies were included in the final analysis, which reported results of 1,247 eyes. The overall complication rate was non-significantly lower in iris fixation (4.4%; 95%CI: 3.6-5.4%, P=0.150) than in AC placement (7.4%; 95%CI: 6.4-7.9%) and scleral fixation (7.4%; 95%CI: 6.5-8.4%). Transient corneal edema was the most common complication in AC placement (29.9%; 95%CI: 2.4-57.5%, P<0.001), compared to scleral fixation (11.9%; 95%CI: 2.6-21.2%) and iris fixation (4.1%; 95%CI: 0.8-7.3%;). Vitreous hemorrhages were more frequently reported following scleral fixation (8.5%; 95%CI: 6.3-11.2%, P=0.006) than in AC placement (5.4%; 95%CI 3.4-8.5%) and iris fixation, 1.4%; 95%CI 0.4-4.2%), and so was IOL decentration/dislocation (8.9%; 95%CI: 6.7-11.8%, P=0.047 compared to 1.1%; 95%CI: 0.4-3.4% and 4.0%; 95%CI: 2.2-7.3%, respectively).
Conclusion: The risks associated with particular techniques should be taken into account in preoperative counseling and planning postoperative treatment.
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Article Synopsis
- The study evaluates the complication rates of various intraocular lens (IOL) placement methods in adults who lack adequate capsular bag support.
- It analyzes data from 15 studies involving 1,247 eyes, finding that iris fixation had a lower overall complication rate (4.4%) compared to anterior chamber (AC) placement (7.4%) and scleral fixation (7.4%).
- Common complications included transient corneal edema primarily in AC placement (29.9%) and higher rates of vitreous hemorrhages and IOL dislocation with scleral fixation.
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