Journal of cataract and refractive surgery最新文献

{"title":"Assessing Ocular Dominance: Rethinking the Current Paradigm.","authors":"Jay S Pepose, Vance Thompson, Phillip Hoopes, George Waring, Ronald Luke Rebenitsch, Scott M MacRae, Kendall E Donaldson, Daniel S Durrie, Susana Marcos","doi":"10.1097/j.jcrs.0000000000001659","DOIUrl":"10.1097/j.jcrs.0000000000001659","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the concordance of a binary, motor sighting test of ocular dominance with a new sensory test using a simultaneous, binocular, head-mounted visual simulator to both identify and quantify the strength of eye dominance (EDS) at near and far.</p><p><strong>Setting: </strong>5 U.S. Private Practices.</p><p><strong>Design: </strong>Prospective, multicentered, double masked, non-interventional, comparative study.</p><p><strong>Methods: </strong>Prospective participants underwent sighting dominance testing using a 'hole-in-the-card' method through their distance refraction. Sensory testing was performed using a wearable, head-mounted, binocular, see-through visual simulator activating an optotunable lens on pupil conjugate plane, set to introduce monocular defocus for masked determination of both ocular preference and eye dominance strength (EDS) at far and at near (correcting the vergence with positive lenses).</p><p><strong>Results: </strong>Of 326 subjects, strong ocular dominance was found at far and at near in 50% (N=163) and 56% (N=183), respectively, with roughly equal remaining distribution between weak and equidominance. In 41% (N=134), the eye chosen to be the dominant eye with the 'hole-in-the-card' sighting method did not match the results from the sensory dominance test. In addition, in 26% (N=85), the subject changed from right eye dominance with the 'hole-in-the-card' to left eye dominance with the sensory EDS test; and 15% (N=49) changed from left to right.</p><p><strong>Conclusions: </strong>Assignment of ocular dominance with the commonly used 'hole-in-the card' test often does not align with the patient's preferred eye using sensory testing with a visual simulator simulating monovision. Further investigation will determine whether both strength and localization of ocular dominance in planning monovision are important factors in predicting patients' satisfaction and adaptation to monovision.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving refractive predictability with high-powered intraocular lenses: Refractive implications of various optic designs.","authors":"David L Cooke, Michael S Seward, Timothy L Cooke","doi":"10.1097/j.jcrs.0000000000001660","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001660","url":null,"abstract":"<p><strong>Purpose: </strong>To identify and reduce refractive prediction errors associated with several common intraocular lens (IOL) models.</p><p><strong>Setting: </strong>Multiple private and university practices across the United States.</p><p><strong>Design: </strong>Retrospective analysis of a large de-identified database.</p><p><strong>Methods: </strong>For all IOL models with at least 800 eyes, prediction errors were plotted as a function of IOL power using Olsen, Barrett, and Cooke K6 (K6) formulas. Plots were categorized as myopic, hyperopic, or neutral profiles, according to their prediction error trends at higher dioptric powers. Prediction modifications (PMODs) were developed with K6 formula, via optical calculations for one IOL (SA60AT), and by empirical data for all others. The PMODs were then tested for their applicability to other modern IOL formulas.</p><p><strong>Results: </strong>Data from 71,183 cataract surgeries were analyzed. At higher powers, Tecnis platform IOLs and one Acrysof model IOL produced unintended myopia. Conversely, enVista platform IOLs produced unintended hyperopia at higher powers. In all cases, results were improved when incorporating PMODs. In 12 of 13 cases, predictability as measured by root-mean-square error was improved (P < 0.03). This included measurements by seven modern formulas in the case of the Tecnis data. Overall, 1306 eyes (1.8%) required more than 0.25 D of adjustment to their predicted refractions. At highest available powers, the needed prediction corrections were -0.61, +0.76, and -0.69 for the Tecnis, enVista, and SN60AT IOLs, respectively.</p><p><strong>Conclusions: </strong>Above 23.5 D, some IOLs cause either myopic or hyperopic prediction errors. Specific adjustments are recommended to improve refractive predictability for several common IOL models.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiformula Prediction Range: a univariate predictor of IOL Power Calculation Accuracy.","authors":"Daniel Romero, Alicia Cárceles Montoya, Jorge L Alió, Alejandro Moya Martínez, Claudia Tarazona Jaimes, Jose Juan Martínez-Toldos","doi":"10.1097/j.jcrs.0000000000001658","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001658","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the influence of range between the predictions of 5 different calculation formulas in IOL power calculation accuracy.</p><p><strong>Settings: </strong>General University Hospital of Elche, Spain.</p><p><strong>Design: </strong>Retrospective Sequential Cohort.</p><p><strong>Methods: </strong>In this retrospective sequential cohort, the LenStar LS900 (Haag-Streit, Koeniz, Switzerland) was used for the preoperative biometry. The predicted spherical equivalent refraction of the implanted IOL were calculated for 5 different formulas: Barrett Universal II, Emmetropia Verifying Optical (EVO) 2.0, Hill RBF-3.0, Kane, PEARL-DGS. Multiformula Prediction Range was defined as the range of the refractive error predicted by the 5 formulas. According to the median of the Multiformula Prediction Range the sample was divided into a low and high spread group (LS and HS respectively).</p><p><strong>Results: </strong>278 eyes were included. The standard deviation of the prediction error was significantly lower in the LS group for all included formulas. For the Barrett Universal II, EVO 2.0, RBF-3.0, Kane and PEARL-DGS formulae, the median absolute error (MdAE) was significantly lower in the LS group compared to the HS group (p-values of 0.001, 0.027, 0.004, 0.028 and 0.035, respectively). The percentage of eyes within the ±0.50D PE range was significantly higher in the LS group for all five analyzed formulas.</p><p><strong>Conclusions: </strong>Multiformula Prediction Range can be a novel univariate predictor of IOL power calculation accuracy and a potential determinant for identifying patient suitable for immediate sequential cataract surgery. Accuracy was consistently higher for all five included formulas in the Low Spread group.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 24-month Analysis of Endothelial Cell Loss at Three Different Positions between Femtosecond Laser-assisted and Conventional Phacoemulsification.","authors":"Enkhtuvshin Shirchinjav, Altantsetseg Altansukh M, Jin-Jhe Wang, Kathleen Sheng-Chuan Ma, Adiyabazar Doyodmaa, Eugene Yu-Chuan Kang M, Ning Hung, Wu-Yong Quan, David Hui-Kang Ma","doi":"10.1097/j.jcrs.0000000000001656","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001656","url":null,"abstract":"<p><strong>Purpose: </strong>To compare long-term changes in endothelial cell loss (ECL) in different corneal regions after femtosecond laser-assisted cataract surgery (FLACS) or conventional phacoemulsification surgery (CPS).</p><p><strong>Setting: </strong>Chang Gung Memorial Hospital, Linkou, Taiwan.</p><p><strong>Design: </strong>Single-center retrospective study.</p><p><strong>Methods: </strong>Adult patients who received a premium IOL via FLACS or CPS were included. Patients with an endothelial count less than 1,500 cells/mm2, NO5/NC5 nuclear sclerosis, and complications during surgery were excluded. All patients were followed at 1, 3, 6, 12, and 24 months postoperatively. ECL was measured at different positions of the cornea: Position 1, the corneal center; Position 2, nearest the main corneal incision; and Position 3, the peripheral region opposite the main wound.</p><p><strong>Results: </strong>48 eyes in the CPS group and 40 eyes in the FLACS group from 75 patients were included. In both groups, ECL was consistently greater at Position 2, and ECL at Positions 1 and 3 remained relatively stable across all time points. At postoperative 3 months at Position 3: the FLACS group had significantly lower ECL than the CPS group. However, at Position 2, ECL continued to increase until 6 months and then stabilized. No significant differences in other endothelial parameters, including the coefficient of variation, percentage of hexagonal cells, or corneal thickness, were observed between the two groups.</p><p><strong>Conclusions: </strong>A significant difference in ECL between FLACS and CPS occurred only in the early postoperative period. ECL was highest near the main wound in both groups; it peaked at 6 months postoperatively and stabilized thereafter.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The traumatic eye snow globe.","authors":"R García-Risco, J Angrill Valls, C García Arumí","doi":"10.1097/j.jcrs.0000000000001649","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001649","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Remote Care in Cataract Surgery: a Systematic Review.","authors":"Joukje C Wanten, Maartje H M Segers, Jos Kleijnen, Noël J C Bauer, Rudy M M A Nuijts","doi":"10.1097/j.jcrs.0000000000001652","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001652","url":null,"abstract":"<p><strong>Topic: </strong>To evaluate the efficacy of currently available digital and remote care applications for postoperative cataract management compared to traditional methods for postoperative clinical measurements.</p><p><strong>Clinical relevance: </strong>With the increasing demand for ophthalmological services and an anticipated shortage of professionals, innovative approaches are needed to optimize care. Cataract surgery, characterized by its high safety profile and turnover rate, is well-suited for digital and remote care solutions, which could enhance the postoperative patient pathway, potentially leading to substantial time and cost savings.</p><p><strong>Methods: </strong>A systematic search was performed in Ovid Embase, Ovid MEDLINE, KSR Evidence, CINAHL, and Cochrane CENTRAL Library for randomized controlled trials (RCTs) and observational studies on digital tools, telemedicine or remote care in postoperative cataract management. Reported outcomes included patient reported outcomes (PROMs), visual acuity, refraction, intraocular pressure, slitlamp and fundus examination, or complication prevalence. The risk of bias was evaluated using the Cochrane Risk-of-Bias Assessment Tool (version 2) and Joanna Briggs Institute Critical appraisal checklists. Data extraction included both qualitative and quantitative information. The protocol was registered at PROSPERO (CRD42024505933).</p><p><strong>Results: </strong>The search identified 11,319 studies, of which 14 were included. These comprised 4 RCTs and 10 observational studies involving 2681 patients. Interventions were categorized into telephone consultation, messaging, automated phone calls, and mobile applications/software. Telephone consultations were effective for follow-up screening, and automated phone calls also showed promising results. Messaging was suggested to improve adherence in the early postoperative period. Visual acuity assessment tools showed potential as screening methods, but exhibited variability compared to conventional methods and had wide 95% limits of agreement. All types of interventions were well-accepted by patients.</p><p><strong>Conclusion: </strong>Early evidence supports a positive impact of implementing digital and remote care tools in the postoperative cataract management pathway, particularly for screening purposes. However, further research is needed to define their roles and develop clinical practice guidelines.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preoperative see-through visual simulation in cataract surgery of presbyopia-correcting intraocular lenses.","authors":"Jorge F S Henriques, Tatiana S M Queirós, Rita Coimbra, Conceição L Lobo Fonseca, Joaquim C N Murta","doi":"10.1097/j.jcrs.0000000000001651","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001651","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the real-life impact of preoperative visual simulations with SimVis Gekko (SVG) on predicting postoperative visual performance in patients undergoing bilateral cataract surgery with trifocal or extended depth of focus (EDOF) intraocular lenses (IOL).</p><p><strong>Setting: </strong>Centro Hospitalar Universitário de Coimbra, Portugal.</p><p><strong>Design: </strong>Single-center prospective observational cohort study.</p><p><strong>Methods: </strong>We included patients aged between 40 and 69 years with mild to moderate cataract and distance corrected visual acuity > 20/50, with indication to underwent cataract surgery with EDOF/trifocal IOL implantation. A trifocal, an EDOF and a monofocal IOL were simulated for each patient preoperatively. Distance, intermediate and near visual acuity (VA), subjective visual performance score (VSco) (from 0 to 10) and stereopsis were measured pre- and postoperatively.</p><p><strong>Results: </strong>A total of 51 patients were tested and 44 (n=44) were included. The mean age of included patients was 56.0 (± 7.9) years, 26 patients received the trifocal IOL and 18 the EDOF IOL. The shape of the VA curve was comparable between preoperative simulation and the achieved postoperative VA for both IOLs; stereopsis was similar with and without simulation; VSco improved at the postoperative for both IOLs and was higher for trifocal group. Ninety-two-point-two percent of patients found the simulation very useful for choosing between IOLs.</p><p><strong>Conclusion: </strong>SVG showed a good ability to simulate EDOF/trifocal IOLs in terms of the shape of the VA curve, stereopsis and VSco. This instrument appears to be very useful for the patient's decision-making process and may reduce dissatisfaction after surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeatability of automatic measurements by a new spectral domain optical coherence biometer and agreement with a validated biometer.","authors":"Arianna Grendele, Alice Galzignato, Kenneth J Hoffer, Catarina P Coutinho, Francesco Calossi, Domenico Schiano-Lomoriello, Giacomo Savini","doi":"10.1097/j.jcrs.0000000000001650","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001650","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the repeatability of measurements obtained with a new spectral-domain optical coherence tomography-based biometer (Colombo IOL II, Moptim) and assess their agreement with those provided by the IOLMaster 700 (Zeiss).</p><p><strong>Setting: </strong>I.R.C.C.S. Bietti Foundation, Rome, Italy.</p><p><strong>Design: </strong>Prospective evaluation of diagnostic test.</p><p><strong>Methods: </strong>Patients underwent 3 consecutive scans with the Colombo IOL II and 1 with the IOLMaster 700. Two groups were analyzed: Group A included a series of consecutive patients undergoing phacoemulsification and Group B a series of subjects with a clear lens. Axial length (AL), keratometry, keratometric astigmatism, anterior chamber depth (ACD), lens thickness (LT), corneal diameter (CD), central corneal thickness (CCT) and retinal thickness (RT) were analyzed. The within-subject standard deviation (Sw), intrasession test variability, coefficient of variation (CoV) and intraclass correlation coefficient (ICC) were calculated for repeatability analysis. 95% limits of agreement were calculated to assess agreement with the IOLMaster 700.</p><p><strong>Results: </strong>Ninety-six unoperated eyes of 96 patients were enrolled (Group A: 45 Group B: 51). The CoV was low for most parameters, as it ranged between 0.04% (AL) to 4.47% (RT) in Group A and from 0.03% (AL) to 2.23% (LT) in Group B. Keratometric astigmatism measurements were less repeatable. Good agreement with the IOLMaster 700 was found for K, LT and AL, whereas the mean ACD was higher by 0.07±0.11 mm with the Colombo IOL II (p <0.0001).</p><p><strong>Conclusion: </strong>Measurements by the Colombo IOL II showed high repeatability and good agreement with those provided by the IOLMaster 700.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon adoption of immediate sequential bilateral cataract surgery in the United States from 2018 to 2022.","authors":"Muhammad Ali, Chen Dun, David F Chang, Hyeck-Soo Son, Fasika A Woreta, Uri S Soiberman, Christina R Prescott, Martin A Makary, Divya Srikumaran","doi":"10.1097/j.jcrs.0000000000001597","DOIUrl":"10.1097/j.jcrs.0000000000001597","url":null,"abstract":"<p><strong>Purpose: </strong>To assess 5-year trends in the rate of immediate sequential bilateral cataract surgery (ISBCS) and surgeon characteristics associated with performing ISBCS.</p><p><strong>Setting: </strong>100% Medicare Fee-For-Service beneficiaries from 2018 to 2022.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>ISBCS cases were identified among patients aged 65 years or older undergoing bilaterally performed cataract surgery (BPCS). Cochrane Armitage trend test was used to assess patient and surgeon characteristics over time. Multivariate logistic regression was used to evaluate surgeon characteristics associated with performing ISBCS.</p><p><strong>Results: </strong>Among 1 190 169 BPCS, 3954 (0.33%) were ISBCS. Quarterly ISBCS rate increased from 2.12 to 5.5 per 1000 BPCS ( P < .001). Among 10 290 surgeons, 1119 (10.87%) performed ISBCS on some patients. Proportion of surgeons performing ISBCS per 1000 cataract surgeons increased from 15.63 during the first quarter of 2018 to 26.55 during the last quarter of 2022 ( P < .001). Among the ISBCS surgeons, the proportion of ISBCS cases per 1000 BPCS doubled from 17.20 in 2018 to 35.50 in 2022 ( P < .001). On multivariate analysis, surgeons in the highest surgical volume quartile (odds ratio [OR], 1.21; 95% CI, 1.01-1.45; Ref: lowest quartile), recent graduates (0 to 10 years: OR, 2.43; 95% CI, 1.87-3.15; Ref: ≥ 31 years), and surgeons in the West (OR, 2.408; 95% CI, 2.052-2.826; Ref: South) had higher odds of performing ISBCS.</p><p><strong>Conclusions: </strong>There was an increased rate of ISBCS possibly suggesting greater interest among patients and surgeons. Although the overall ISBCS rate remained low, the number of surgeons performing ISBCS increased. Higher volume surgeons, recent graduates, and those practicing in the West were more likely to perform ISBCS.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"210-217"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative complication rates in intraocular lens placement and fixation methods for inadequate capsular bag support: review and meta-analysis.","authors":"Piotr Kanclerz, Szymon Adam Radomski, Idan Hecht, Raimo Tuuminen","doi":"10.1097/j.jcrs.0000000000001572","DOIUrl":"10.1097/j.jcrs.0000000000001572","url":null,"abstract":"<p><strong>Topic: </strong>To evaluate the complication rates of different intraocular lens (IOL) placement methods in adults with inadequate capsular bag support.</p><p><strong>Clinical relevance: </strong>The surgical correction of inadequate capsular bag support for the IOL harbors several challenges, and there is a wide range of surgical procedures.</p><p><strong>Methods: </strong>For the purpose of this meta-analysis, surgical methods were grouped based on the location of IOL placement: (1) anterior chamber (AC) placement; (2) iris fixation, which included prepupillary or retropupillary placement of an iris-claw IOL, or iris suturing of an IOL; and (3) scleral fixation, which included scleral sutured and sutureless techniques. Only studies comparing the results of 2 or more different placement methods were analyzed. The study protocol has been registered in the PROSPERO database (CRD42023458557).</p><p><strong>Results: </strong>15 studies were included in the final analysis, which reported results of 1247 eyes. The overall complication rate was nonsignificantly lower in iris fixation (4.4%; 95% CI, 3.6%-5.4%, P = .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 < .001), compared with 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 after scleral fixation (8.5%; 95% CI, 6.3%-11.2%, P = .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 = .047 compared with 1.1%; 95% CI, 0.4%-3.4% and 4.0%; 95% CI, 2.2%-7.3%, respectively).</p><p><strong>Conclusions: </strong>The risks associated with particular techniques should be taken into account in preoperative counseling and planning postoperative treatment.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"257-266"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}