Pars Plana Vitrectomy Versus Anterior Vitrectomy In Scleral-Fixated Intraocular Lenses Implantation: A Systematic Review And Meta-Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: FP03.09 | Type: Free paper | DOI: 10.82333/p3n9-zb44
Authors: Dr Hashem Abu Serhan* 1 , Dr Abdullah Ahmed 2 , Dr Mahrukh Chaudhry 2 , Dr Fakiha Ahmed 3 , Dr Arsalan Nadeem 2 , Dr Basum Hayat 4 , A/Prof. Ahmed B. Sallam 5
1Department of Ophthalmology,Hamad Medical Corporation,Doha,Qatar, 2Department of Medicine,Allama Iqbal Medical College,Lahore,Pakistan, 3Department of Medicine,Foundation University,Islamabad,Pakistan, 4Department of Medicine,Shifa College of Medicine,Islamabad,Pakistan, 5Department of Ophthalmology, Jones Eye Institute,University of Arkansas for Medical Sciences,Arkansas ,United States
Purpose
To compare the complications risk and surgical outcomes between pars plana vitrectomy (PPV) and anterior vitrectomy (AV) approaches in scleral-fixated intraocular lens (SFIOL) implantation.
Setting
A systematic review and meta-analysis.
Methods
We comprehensively searched PubMed, Medline, Scopus, Cochrane Library, EMBASE, and Google Scholar. We included studies comparing PPV and AV approaches for SFIOL implantation. Primary outcomes included postoperative complications such as retinal detachment, vitreous prolapse, and cystoid macular edema as well as changes in best-corrected visual acuity (BCVA). The GRADE framework was used to assess the certainty of evidence.
Results
Five studies encompassing 522 eyes were included. PPV was associated with a significantly lower risk of RD (OR = 0.11, 95% CI: 0.02–0.57, p < 0.01) and vitreous prolapse (OR = 0.10, 95% CI: 0.02–0.60, p < 0.01) compared to AV. However, PPV had a higher risk of IOL capture (OR = 3.12, 95% CI: 1.30–7.46, p < 0.01). No significant differences were observed in the risks of elevated IOP, CME, or vitreous hemorrhage. Postoperative BCVA improvement was comparable between both techniques (MD = -0.05, 95% CI: -0.12 to 0.02). GRADE assessment indicated that the certainty of evidence ranged from very low to moderate.
Conclusions
PPV is associated with a reduced risk of RD and vitreous prolapse but an increased risk of IOL capture compared to AV in SFIOL implantation. Both techniques demonstrated similar risks for other complications and comparable visual outcomes. Surgeons should consider patient-specific factors and surgical expertise when selecting the appropriate approach.