Implantable Collamer Lenses In Patients With Keratoconus: A Systematic Review And Meta-Analysis
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1187 | Type: Free paper | DOI: 10.82333/nt6x-kq85
Authors: Ali Alkhabbaz 1 , Mohammad Karam 2 , Andre Pollmann 3 , Tsz Hin Alexander Lau 4 , Khaldoon Abbas 5 , Hamad Al-Awadhi 6 , Siddharth Nath* 4 , Samir Jabbour 7
1Al Bahar Eye Center, Ministry of Health,Kuwait City,Kuwait, 2Al Bahar Eye Center, Ministry of Health,Kuwait City,Kuwait;Department of Ophthalmology,McGill University,Montreal,Canada, 3Department of Ophthalmology,University of Montreal,Montreal,Canada, 4Department of Ophthalmology,McGill University,Montreal,Canada, 5University of British Columbia,Vancouver,Canada, 6Department of Ophthalmology,Al Bahar Eye Center, Ministry of Health,Kuwait City,Kuwait, 7Department of Ophthalmology,University of Montreal,Montreal,Canada;Department of Ophthalmology,McGill University,Montreal,Canada;T.H. Chan School of Public Health,Harvard University,Boston,United States
Purpose
To assess the efficacy of implantable collamer lenses (ICL) for patients with Keratoconus.
Setting
Systematic review and meta-analysis
Methods
A single-arm systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and a search of electronic information was conducted to identify all studies of ICL efficacy in patients with keratoconus. The primary outcome measures were corrected (CDVA), uncorrected distance visual acuity (UDVA), and manifest cylinder. Secondary outcome measures included uncorrected close visual acuity (UCVA), spherical equivalent, astigmatism, adverse effects, re-operation, contrast sensitivity, total aberrations, and endothelial cell loss. Our analyses were summarized by calculating standardized mean differences (SMDs) using random effects meta-analysis.
Results
Fourteen eligible studies that enrolled 397 eyes were identified. At 1 month, 6 months, and 1 year post-operatively, there was no statistically significant change in CDVA compared to preoperative values. At 6 months post-operatively, there was an improvement in logMAR UDVA compared to preoperative values; however at 1 year this change was not statistically significant (mean change: 0.741, P = 0.007 and 0.822, P =0.153, respectively). At 1 year post-operatively there was a statistically significantly improvement in mean UCVA compared to pre-operative values (mean: 0.452, P = 0.022). One year post-operatively, there was a statistically significant change in SE compared to pre-operative values (mean change: -7.691 D, P = 0.000, respectively).
Conclusions
This single arm meta-analysis, incorporating 14 studies and 397 eyes, suggests that ICL use in eyes with stable keratoconus improves UDVA in the average eye by up to 7 lines (logMar mean difference 0.7) on the vision chart at 6 months post-operatively; however, the anlaysis did not detect a significant difference at 1 year . There was a reduction in spherical error and astigmatism. Limitations of this analysis are the limited number of studies available for meta-analysis of UDVA thereby decreasing the power of the analysis and the relatively short time frame of included studies.