Capsular Tension Ring Implantation for Intraocular Lens Position: A Systematic Review and Meta-Analysis.

IF 7.8 1区 医学 Q1 OPHTHALMOLOGY
Haowen Lin, Yu Zhang, Xiaohang Xie, Xuhua Tan, Ling Jin, Jiaqing Zhang, Lixia Luo, Yizhi Liu
{"title":"Capsular Tension Ring Implantation for Intraocular Lens Position: A Systematic Review and Meta-Analysis.","authors":"Haowen Lin, Yu Zhang, Xiaohang Xie, Xuhua Tan, Ling Jin, Jiaqing Zhang, Lixia Luo, Yizhi Liu","doi":"10.1001/jamaophthalmol.2025.1623","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>There is currently no consensus regarding the association of capsular tension ring (CTR) on intraocular lens (IOL) position or the indications for its implantation.</p><p><strong>Objective: </strong>To evaluate the association of CTR implantation on IOL position.</p><p><strong>Data sources: </strong>PubMed, Embase, and Cochrane Library were searched from their inception to October 18, 2024.</p><p><strong>Study selection: </strong>Randomized clinical trials (RCTs) or prospective cohorts reporting the effect or association of CTR on postoperative anterior chamber depth (ACD), IOL decentration, tilt, or rotation.</p><p><strong>Data extraction and synthesis: </strong>Data extraction was conducted by 2 reviewers and verified by another for accuracy. Mean difference (MD) was used to synthesize the effect measures, and subgroup analyses were conducted according to IOL haptic design (C-loop and plate haptic) and whether the patient had high myopia.</p><p><strong>Main outcome and measures: </strong>Postoperative ACD and IOL decentration, tilt, and rotation.</p><p><strong>Results: </strong>A total of 11 RCTs and 7 cohort studies, involving 809 eyes with CTR and 822 eyes without CTR, were included in this meta-analysis. The analysis revealed that IOL tilt (MD, -1.04°; 95% CI, -2.05° to -0.03°; P = .04) and rotation (MD, -0.82°; 95% CI, -1.27° to -0.37°; P < .001) were smaller in the CTR group compared with the control group. The subgroup analysis of ACD (I2 = 70.7%; P = .03), decentration (I2 = 66.5%, P = .08), and tilt (I2 = 76.7%, P = .01) revealed a heterogeneity between the subgroups stratified according to IOL haptic design. Additionally, subgroup analysis demonstrated that CTR group showed a deeper ACD in eyes implanted with plate haptic IOLs (MD, 0.11 mm; 95% CI, 0.02 to 0.20 mm; P = .01), and a smaller IOL tilt in highly myopic eyes (MD, -1.43°; 95% CI, -2.59° to -0.26°; P = .02) compared with the control group.</p><p><strong>Conclusions and relevance: </strong>CTR implantation was associated with enhanced stability of IOL rotation in this meta-analysis, while only reducing IOL tilt in high myopia. While the direct clinical relevance of these results could not be determined from this investigation, these findings provide evidence supporting use of CTR implantation when toric IOLs have been implanted or with high myopia, although a hyperopic refractive shift after implantation of plate haptic IOLs may require target refraction adjustment.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163718/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamaophthalmol.2025.1623","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Importance: There is currently no consensus regarding the association of capsular tension ring (CTR) on intraocular lens (IOL) position or the indications for its implantation.

Objective: To evaluate the association of CTR implantation on IOL position.

Data sources: PubMed, Embase, and Cochrane Library were searched from their inception to October 18, 2024.

Study selection: Randomized clinical trials (RCTs) or prospective cohorts reporting the effect or association of CTR on postoperative anterior chamber depth (ACD), IOL decentration, tilt, or rotation.

Data extraction and synthesis: Data extraction was conducted by 2 reviewers and verified by another for accuracy. Mean difference (MD) was used to synthesize the effect measures, and subgroup analyses were conducted according to IOL haptic design (C-loop and plate haptic) and whether the patient had high myopia.

Main outcome and measures: Postoperative ACD and IOL decentration, tilt, and rotation.

Results: A total of 11 RCTs and 7 cohort studies, involving 809 eyes with CTR and 822 eyes without CTR, were included in this meta-analysis. The analysis revealed that IOL tilt (MD, -1.04°; 95% CI, -2.05° to -0.03°; P = .04) and rotation (MD, -0.82°; 95% CI, -1.27° to -0.37°; P < .001) were smaller in the CTR group compared with the control group. The subgroup analysis of ACD (I2 = 70.7%; P = .03), decentration (I2 = 66.5%, P = .08), and tilt (I2 = 76.7%, P = .01) revealed a heterogeneity between the subgroups stratified according to IOL haptic design. Additionally, subgroup analysis demonstrated that CTR group showed a deeper ACD in eyes implanted with plate haptic IOLs (MD, 0.11 mm; 95% CI, 0.02 to 0.20 mm; P = .01), and a smaller IOL tilt in highly myopic eyes (MD, -1.43°; 95% CI, -2.59° to -0.26°; P = .02) compared with the control group.

Conclusions and relevance: CTR implantation was associated with enhanced stability of IOL rotation in this meta-analysis, while only reducing IOL tilt in high myopia. While the direct clinical relevance of these results could not be determined from this investigation, these findings provide evidence supporting use of CTR implantation when toric IOLs have been implanted or with high myopia, although a hyperopic refractive shift after implantation of plate haptic IOLs may require target refraction adjustment.

人工晶状体位置囊膜张力环植入术:系统回顾和荟萃分析。
重要性:目前,关于人工晶状体(IOL)位置和植入术的适应症,荚膜张力环(CTR)的相关性尚无共识。目的:探讨CTR植入与人工晶状体位置的关系。数据来源:PubMed, Embase和Cochrane图书馆从其成立到2024年10月18日进行检索。研究选择:随机临床试验(rct)或前瞻性队列报告CTR对术后前房深度(ACD)、人工晶状体脱位、倾斜或旋转的影响或关联。数据提取和综合:数据提取由2名审稿人进行,并由另一名审稿人进行准确性验证。采用平均差(Mean difference, MD)综合疗效指标,并根据人工晶状体触觉设计(c环和板形触觉)及患者是否高度近视进行亚组分析。主要结果和措施:术后ACD和IOL脱位、倾斜和旋转。结果:本meta分析共纳入11项随机对照试验和7项队列研究,共涉及CTR组809只眼和无CTR组822只眼。分析显示:人工晶状体倾斜(MD, -1.04°;95% CI, -2.05°~ -0.03°;P = .04)和旋转(MD, -0.82°;95% CI, -1.27°至-0.37°;结论和相关性:在本荟萃分析中,CTR植入与增强IOL旋转稳定性相关,而仅降低高度近视的IOL倾斜。虽然这些结果的直接临床相关性不能从本研究中确定,但这些发现提供了证据,支持在植入环形iol或高度近视时使用CTR植入术,尽管植入片状触觉iol后的远视屈光移位可能需要调整目标屈光。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
JAMA ophthalmology
JAMA ophthalmology OPHTHALMOLOGY-
CiteScore
13.20
自引率
3.70%
发文量
340
期刊介绍: JAMA Ophthalmology, with a rich history of continuous publication since 1869, stands as a distinguished international, peer-reviewed journal dedicated to ophthalmology and visual science. In 2019, the journal proudly commemorated 150 years of uninterrupted service to the field. As a member of the esteemed JAMA Network, a consortium renowned for its peer-reviewed general medical and specialty publications, JAMA Ophthalmology upholds the highest standards of excellence in disseminating cutting-edge research and insights. Join us in celebrating our legacy and advancing the frontiers of ophthalmology and visual science.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信