Systematic Review And Meta-Analysis Of Refractive Intraocular Lens Implementation In Keratoplasty: Efficacy, Complications, And Patient Outcomes.
Published 2024 - 42nd Congress of the ESCRS
Reference: PP19.04 | Type: Free paper | DOI: 10.82333/jtzd-kk44
Authors: Ghada Aljuhani* 1 , Abdulrahman Alahmadi 2
1Saudi Commission for Health Specialties,Madinah,Saudi Arabia, 2Ophthalmology consultant, cornea, and refractive surgery, Ohud Hospital,Madinah,Saudi Arabia
Purpose
Keratoplasty is valuable surgical management in various corneal pathologies, however, achieving optimal refractive status following keratoplasty remains challenging due to irregular astigmatism and high refractive errors. Multiple approaches have been developed to correct residual refractive errors and to improve visual acuity, including medical, laser, and surgical options. One surgical management of post-keratoplasty refractive power correction is intraocular lens implantation (IOL). This study aimed to comprehensively review the current data available for the effectiveness and safety of secondary IOL implantation in post-keratoplasty patients.
Setting
NA
Methods
Tow databases were searched for the following mesh terms: keratoplasty, implantable Collamer lens, ICL, iris claw, and Piggyback. This review adhered to and followed the PRISMA guideline 2020. Studies reporting surgical outcomes such as visual acuity, refractive error, and complications were included.
Results
Our review included 12 studies, a total of 167 eyes. Among the articles that met our inclusion criteria, six assessed the efficacy of the ICL; four evaluated iris-claw IOL, and two examined piggyback IOL. We used the Spherical equivalent (SE) as a statistical outcome measure, and we found that across the included studies, the mean standardized difference of the SE was 2.09 with 95% CI (1.50 – 2.68) P < 0.001. The combined safety index was 0.78+/-0.43, while the combined efficacy index was 1.26+/-0.47.
Conclusions
In conclusion, secondary IOL implantation is an effective modality of treating residual refractive error in post-keratoplasty patients, as evidenced by significant improvement in spherical equivalent across included studies. The combined safety index indicates an acceptable safety profile for this type of surgical management. Further randomized control trials are needed to evaluate secondary IOL implantation's long-term efficacy and safety in post-keratoplasty patients.