The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: A systematic review and meta-analysis

Abstract

This meta-analysis aims to evaluate the incidence of secondary glaucoma in patients under the age of 2 years who underwent congenital cataract surgery with or without primary intraocular lens (IOL) implantation. Methods An electronic literature search was performed in Medline, EMBASE, and Web of Science databases to retrieve studies between January 2011 and November 2018. Patients with congenital cataract who did primary IOL implantation, aphakia, or secondary IOL implantation followed by receiving extraction surgery were included in this study. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. Long-term incidences of secondary glaucoma, which developed at least one year after cataract surgery, were considered and discussed as clinical outcomes in each cohort. The pooled data were analyzed according to a random effects model. Results Eight publications involving 892 eyes were included in the current meta-analysis. In the general population of eyes with congenital cataract, the long-term incidence of secondary glaucoma was lower (P = 0.06) in eyes with primary IOL (9.5%) than in eyes without primary IOL (15.1%), including aphakia and secondary IOL. The pooled risk ratio (RR) favors primary IOL implantation in all patients (RR = 0.63). For bilateral congenital cataract, the incidence was 6.7% in eyes with primary IOL implantation, which is significantly lower than the 16.7%

School-based epidemiology study of myopia in Tianjin, China

“…The Spot photoscreener we used in this study has been shown to have good consistency with cycloplegic refraction test in our previous study [ 5 , 31 , 32 ]. It is also reported to have an overall high sensitivity (91.7%) and specificity (82.6%) in detecting amblyogenic risk factors in children [ 10 ], suggesting its good test accuracy.…”

Outcomes of Bilateral Cataracts Removed in Infants 1 to 7 Months of Age Using the Toddler Aphakia and Pseudophakia Treatment Study Registry

“…Some have used retrospective data to suggest that primary IOL implantation in children is protective against the development of glaucoma. 6,44 However, as identified elsewhere, retrospective data on IOL implantation is unavoidably affected by confounding bias. Intraocular lenses are implanted less commonly in the youngest infants and eyes with significant comorbidities.…”

Systematic Review and Meta-Analysis of Comparing Phacoemulsification Combined with goniosynechialysis to other mainstream procedures in treating patients with angle-closure glaucoma

“…The thick lens and short axial length of eyeball are very common for the patients with ACG, which could cause shallow anterior chamber and pupillary block to a large extent. [18,19] Nowadays, Phaco is the safe way to deepen the anterior chamber by removing the lens, and the thinner IOL could also eliminate the possibility of pupillary block. Moreover, the intraoperative irrigation pressure in the closed anterior chamber, as well as perfusate flush, also exert forces to reopen the angle.…”