Safety and Efficacy of Posterior Chamber Phakic Implantable Collamer Lenses in Patients with Keratoconus: A Systematic Review and Meta-Analysis.

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-11-27 DOI:10.1016/j.ajo.2024.11.013

Ali A Alkhabbaz, Mohammad H Karam, André S Pollmann, Siddharth Nath, Tsz Hin Alexander Lau, Hamad Al-Awadhi, Khaldon Abbas, Samir Jabbour

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引用次数: 0

Abstract

Purpose: To assess the safety and efficacy of phakic implantable collamer lenses (ICLs) in patients with keratoconus.

Design: Systematic review and meta-analysis.

Methods: We conducted a pre- and post-intervention single-arm systematic review and meta-analysis in line with guidelines from the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 Consensus Statement. We searched five electronic databases and the grey literature for any studies evaluating ICLs in the setting of keratoconus. Our primary outcomes were the corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), and manifest cylinder astigmatism. Secondary outcomes included uncorrected near visual acuity (UNVA), spherical equivalent, refractive astigmatism, higher-order aberrations (HOAs), endothelial cell density (ECD), intraocular pressure (IOP), and incidence of adverse events. We summarized our analyses by calculating standardized mean differences (SMDs) with associated 95% confidence intervals (CIs) using random-effects meta-analysis.

Results: Sixteen observational studies, totalling 397 eyes, were eligible. Post-operatively, there was no statistically significant improvement in CDVA (SMD: -0.97, 95% CI: -1.99 to 0.05, p<0.06); there was a statistically significant improvement in UDVA (SMD: -5.41, 95% CI: -0.704 to -3.78, p<0.05), manifest cylinder (SMD: 2.27, 95% CI: 1.83 to 2.70, p<0.05), spherical equivalent (SMD:-4.66, 95% CI: -5.63 to 3.68, p<0.05), and refractive astigmatism (SMD: 2.22, 95% CI: 1.03 to 3.41, p<0.05). No significant adverse events occurred.

Conclusions: Use of ICLs in patients with keratoconus is safe and effective, resulting in significant improvements in a myriad of visual and refractive measures. Our results remain limited by the observational design of included studies as well as the limited follow-up duration.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.