Advisability of primary intraocular lens implantation for infants under
2: A systematic review and meta-analysis
Abstract
Purposes: The present meta-analysis compared the postoperative visual
performance of primary intraocular lens (IOL) implantation and primary
aphakia in cataract infants. Methods: We performed a systematic
literature search in PubMed, EMBASE and Science Direct. Postoperative
visual acuity (VA) and complications were extracted and pooled. Results:
Four randomized controlled trails (RCTs) and seven retrospective studies
were included. The postoperative VA in primary IOL group was better than
that in primary aphakia group [MD=-0.12, 95% CI: (-0.19, -0.05),
p=0.91]. There was no significant difference in the incidence of
glaucoma, retinal detachment and nystagmus between primary IOL group and
primary aphakia group [OR=1.27, 95% CI: (0.79, 2.05), p=0.84 for
glaucoma; OR=0.49, 95%CI: (0.07, 3.30), p=0.34 for retinal detachment;;
OR=1.11, 95%CI: (0.62, 1.98), p=0.73 for nystagmus]. Analysis of
unilateral subgroup indicated there were fewer infants with strabismus
in primary IOL group compared with primary aphakia group [OR=0.40,
95% CI: (0.21, 0.79), p=0.46]. The primary IOL group needed more
visual axis opacification (VAO) clearing than primary aphakia group
[OR=9.33, 95%CI: (5.21, 16.73), p=0.27]. Conclusion: Primary IOL
implantation provided more visual benefits. IOL implantation may
decrease the incidence of strabismus in comparison with primary aphakia
in unilateral subgroup. However, these advantages could be offset by a
higher VAO clearing surgery.