Potential Adverse Events Associated With Posterior Chamber Phakic Iols: A Systematic Review And Meta-Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: FP19.13 | Type: Free paper | DOI: 10.82333/wjew-dd16
Authors: Ms Maria Laura Passaro* 1 , Ms Matilde Buzzi 2 , Dr Riaz Qureshi 3 , Dr Ving Fai Chang 4 , Dr Yuhao Zou 5 , Prof. Rita Mencucci 2 , Dr Ersilia Lucenteforte 6 , Prof. Vito Romano 7 , Prof. Gianni Virgili 2
1Department of Medicine and Health Sciences 'V.Tiberio',University of Molise,Campobasso,Italy, 2Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA),University of Florence,Florence,Italy, 3Department of Ophthalmology,University of Colorado Anschutz Medical Campus,Denver,United States, 4Center for Public Health,Queen's University Belfast,Belfast,United Kingdom, 5Department of Ophthalmology,University of Electronic Science and Technology of China,Chengdu,China, 6Department of Statistics, Computer Science and Applications "G. Parenti",University of Florence,Florence,Italy, 7Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health,University of Brescia,Brescia,Italy
Purpose
To estimate the incidence of complications following posterior chamber phakic intraocular lens implantation and to evaluate temporal and geographic variation in reported outcomes.
Setting
Systematic review and meta-analysis
Methods
This meta-analysis included randomized and nonrandomized trials and observational studies involving adults undergoing posterior chamber phakic intraocular lens implantation. PubMed, Scopus, WANFANG Data, and China National Knowledge Infrastructure were searched without language or date restrictions. The primary outcome was the incidence of IOL explantation. Secondary outcomes included the onset of IOL rotation or displacement, anterior capsular opacification, cataract formation, iris atrophy, retinal detachment, macular oedema, pupillary block, glaucoma, pupil ovalisation, intraocular infection, endothelial failure, and iris cyst. Incidence was modeled as events per 1,000 person-years using negative binomial regression with robust variance.
Results
A total of 214 studies (45,027 eyes) were included, most involving the V4c model of the Implantable Collamer Lens (92.7%). Rotation or displacement occurred at 4.2 per 1,000 person-years and explantation at 3.1 per 1,000 person-years, corresponding to approximately about 2 rotated lenses and explantations per 100 eyes followed for 5 years, assuming constant hazards. Anterior segment events were less frequent, and posterior events were rare (retinal detachment, 0.4; macular edema, 0.3 per 1,000 person-years). Complication rates decreased in more recent studies and were lower in Asian cohorts.
Conclusions
PCPIOL implantation is associated with a low incidence of complications, and vision-threatening events appear to be very rare. However, predominantly short follow-up and high risk of bias likely lead to underestimation of late events. These incidence estimates support early postoperative assessment of centration, axis alignment, and vault, and long-term endothelial and anterior segment monitoring.