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Meta-Analysis
. 2014 Aug 12;9(8):e104649.
doi: 10.1371/journal.pone.0104649. eCollection 2014.

Implantable collamer lens versus iris-fixed phakic intraocular lens implantation to correct myopia: a meta-analysis

Guan-Lu Liang  1 , Jing Wu  1 , Jun-Ting Shi  2 , Jian Liu  1 , Feng-Ying He  1 , Wen Xu  1
Affiliations
Meta-Analysis

Implantable collamer lens versus iris-fixed phakic intraocular lens implantation to correct myopia: a meta-analysis

Guan-Lu Liang et al. PLoS One. .

Abstract

This study is a meta-analysis comparing the efficacy, predictability, and safety of correcting myopia via implantation of two types of phakic intraocular lens (PIOLs): the implantable collamer lens (ICL) and iris-fixed PIOL. The Cochrane library, Pubmed, and EMBASE were searched. Study selection, data exclusion, and quality assessment were performed by two independent observers. The pooled relative risk (RR), pooled standardized mean difference (SMD), and their 95% confidence intervals (CIs) were used to compare lenses. Seven studies, involving 511 eyes, were included. The pooled SMD in postoperative uncorrected distance visual acuity (UDVA) comparing ICLs to iris-fixed PIOLs was -0.22 (95% CI, -0.58 to 0.13; P = .22). The pooled RR values of UDVA of 20/20 or better and of 20/40 or better comparing ICLs to iris-fixed PIOLs were 1.15 (95% CI, 0.89 to 1.47; P = .29) and 1.01 (95% CI, 0.95 to 1.08; P = .75), respectively. The pooled RR of loss of best spectacle-corrected visual acuity (BSCVA) and gain in BSCVA comparing ICLs to iris-fixed PIOLs were 1.20 (95% CI, 0.24 to 6.00; P = .82) and 1.14 (95% CI, 0.89 to 1.48; P = .31), respectively. The pooled RR comparing ICLs to iris-fixed PIOLs was 0.78 (95% CI, 0.29 to 2.12; P = .63) for all reported complications and 2.80 (95% CI, 1.04 to 7.52; P = .04) for severe complications. The pooled RR of achieving a result within ± 0.5 D (diopter) of the intended target comparing ICLs to iris-fixed PIOLs was 1.35 (95% CI, 1.04 to 1.77; P = .03). Overall, there is no significant difference in efficacy between the two types of PIOLs or in safety, except that the ICL is associated with a greater incidence of severe complications, especially anterior subcapsular cataract, primarily in the Version 2 and Version 3 groups. However, ICL has better predictability.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart of study selection process.
Figure 2
Figure 2. Forest plot comparing uncorrected distance visual acuity (log MAR) after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens (First author and year of publication of each study given) (CI =  confidence interval; SMD =  standardized mean difference).
Figure 3
Figure 3. Forest plot comparing uncorrected distance visual acuity (log MAR) after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens according to different following-up time.
Short term means short-term following-up, long term means long-term following-up. (First author and year of publication of each study given) (CI =  confidence interval; SMD =  standardized mean difference).
Figure 4
Figure 4. Forest plot comparing the number of eyes achieving 20/20 (Snellen) or better after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 5
Figure 5. Forest plot comparing the number of eyes achieving 20/40 (Snellen) or better after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 6
Figure 6. Forest plot comparing the number of eyes losing one or more lines of best spectacle corrected visual acuity after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 7
Figure 7. Forest plot comparing the number of eyes gaining one or more lines of spectacle corrected visual acuity after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 8
Figure 8. Forest plot comparing all the reported complications of eyes after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 9
Figure 9. Forest plot comparing the eyes with severe complications after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
Figure 10
Figure 10. Forest plot comparing the number of eyes achieving a postoperative spherical equivalent within ±0.5 D of the intended target after implanting Implantable Collamer Lens and iris-fixed phakic intraocular lens.
(First author and year of publication of each study given) (CI =  confidence interval; RR =  relative risk).
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