Comparison Of Carlevale And Artisan Retropupillary Iris-Claw Intraocular Lens Fixation For Managing Aphakia: A Systematic Review And Meta-Analysis
Published 2025 - 43rd Congress of the ESCRS
Reference: PP08.01 | Type: Free paper | DOI: 10.82333/gbqg-wa02
Authors: Sang-Mok Lee* 1 , Si-Hoon Park 2 , Tae Keun Yoo 2 , Jae Hyoung Park 2 , Beom Jin Cho 1 , Kee Yong Choi 2 , Jong Woo Kim 2
1Hangil Eye Hospital,Incheon,Korea, Republic Of;Catholic Kwandong University College of Medicine,Incheon,Korea, Republic Of, 2Hangil Eye Hospital,Incheon,Korea, Republic Of
Purpose
Carlevale and retropupillary iris-claw Artisan intra-ocular lenses (IOLs) are methods for correcting aphakia in eyes lacking capsular support. The optimal lens choice in terms of visual outcomes and refractive stability remains unclear. This meta-analysis compares the Carlevale and retropupillary Artisan IOLs to determine their relative effectiveness and safety.
Setting
A systematic review and meta-analysis comparing Carlevale and retropupillary iris-claw Artisan IOLs for correction of aphakia in the absence of capsular support.
Methods
We searched PubMed, Embase and Cochrane for studies comparing Carlevale to retropupillary iris-claw (Artisan) in aphakic patients. The main outcomes were best-corrected visual acuity (BCVA), surgically induced astigmatism (SIA), and mean refractive error. We defined SIA as the difference between post-operative astigmatism and pre-operative astigmatism. Statistical analysis was performed using Review Manager Web (Cochrane Collaboration). Heterogeneity was assessed with I2 statistics.
Results
631 eyes from five studies were included. Carlevale IOL was implanted in 229 (36.3%) eyes. The mean age was 70.1 ± 14.1 years, 61.18% were male. Follow up ranged from 1.3 to 11.5 months. There was no statistical significance in post-operative BCVA between IOLs (MD -0.01 logMAR; 95% Cl -0.13-0.11; p = 0.91; I2 = 43%). SIA was lower in patients with Carlevale IOLs (MD −0.53 D; 95% CI: −1.03 to −0.04; p = 0.03; I2 = 74%). Mean refractive error was also significantly lower in patients with Carlevale implantation (MD -0.70 D; 95% CI: -0.92 to -0.48; p < 0.00001; I2 = 36%).
Conclusions
In aphakic patients, Carlevale and retropupillary iris-claw IOLs provide comparable visual outcomes. While Carlevale implantation is associated with less SIA, it may result in a more myopic outcome than intended. Given the risks of iris inflammation and pupil distortion associated with iris-claw IOLs, the Carlevale IOL presents a safe, sutureless alternative for correction of aphakia in the absence of capsule support.