Open AccessAdvisability of primary intraocular lens implantation for infants under 2: A systematic review and meta‐analysis
Author(s) -
Jin Shanshan,
Zhang Jingshang,
Wang Jinda,
Yusufu Mayinuer,
Cao Kai,
Zhu Guyu,
He Hailong,
Wan Xiu Hua
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14143
Subject(s) - aphakia , medicine , ophthalmology , intraocular lens , strabismus , retinal detachment , incidence (geometry) , visual acuity , glaucoma , cochrane library , retinal , surgery , randomized controlled trial , physics , optics
Purposes The present meta‐analysis compared the postoperative visual performance of primary intraocular lens (IOL) implantation and primary aphakia in cataract infants. Methods PubMed, Embase, Science Direct and Cochrane Library were searched, and postoperative visual acuity (VA) and complications were extracted and pooled. Results Three randomised controlled trails (RCTs) and five retrospective studies were included. The postoperative VA of children younger than 4.5 years in primary IOL group was better than that in primary aphakia group [MD = −0.14, 95% CI: (−0.23, −0.06), P = .90]. The subgroup analysis based on RCTs and on unilateral cataract surgery revealed the same result. There was no significant difference in the incidence of glaucoma, strabismus, retinal detachment and nystagmus between primary IOL group and primary aphakia group [OR = 1.02, 95% CI: (0.62, 1.68), P = .48 for glaucoma; OR = 0.76, 95% CI: (0.30, 1.90), P = .05 for strabismus; OR = 0.49, 95% CI: (0.07, 3.30), P = .34 for retinal detachment; OR = 1.26, 95% CI: (0.68, 2.36), P = .92 for nystagmus]. The proportion of patients requiring postoperative visual axis opacification (VAO) clearing was higher in primary IOL group than that in primary aphakia group [OR = 9.22, 95% CI: (4.74, 17.96), P = .16]. Conclusion For infants under 2 years of age, primary IOL implantation would provide more visual benefits compared with primary aphakia did, though the benefits would taper off with the age reaching 4.5 years. Moreover, the current study revealed a higher VAO incidence r in primary IOL implantation group.