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SCLERAL FIXATION OF CARLEVALE INTRAOCULAR LENS A Systematic Review and Meta-Analysis

Journal

RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 43, Issue 10, Pages 1750-1762

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000003873

Keywords

aphakia; intraocular lens; pars plana vitrectomy; sutureless intraocular lens; scleral fixation

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This study demonstrates that Carlevale IOL implantation can significantly improve BCVA and has a low incidence rate of postoperative complications.
Purpose:The mean change in best-corrected visual acuity (BCVA), intraocular pressure, and endothelial cell counts after intraocular lens (IOL) implantation and the incidence rate of postoperative complications were estimated by systematic review and meta-analysis to assess the surgical and refractive outcomes of the sutureless scleral fixation Carlevale IOL.Methods:A literature search was conducted using PubMed, Embase, and Scopus. The weighted mean difference (WMD) was used to present the mean change in BCVA, intraocular pressure, and endothelial cell count after IOL implantation, whereas a proportional meta-analysis was used to estimate the pooled incidence rate of postoperative complications.Results:In the meta-analysis of 13 studies involving 550 eyes, the pooled WMD of the mean change in BCVA showed a significant improvement in BCVA in patients who underwent Carlevale IOL implantation (WMD = 0.38, 95% confidence interval: 0.30-0.46, P < 0.001; heterogeneity [I-2] = 52.02%). The subgroup analyses indicated that the mean change in BCVA was not significantly higher according to the last follow-up visit, with no statistically significant subgroup effect (P = 0.21) (WMD up to 6 months: 0.34, 95% confidence interval: 0.23-0.45, I-2 = 58.32%, WMD up to 24 months: 0.42, 95% confidence interval: 0.34-0.51, I-2 = 38.08%). In the meta-analysis of 16 studies involving 608 eyes, the pooled incidence rate of postoperative complications was equal to 0.22 (95% confidence interval: 0.13-0.32, I-2 = 84.87, P <= 0.001).Conclusion:Carlevale IOL implantation represents a reliable method of restoring vision in eyes with missing capsular or zonular support.

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