Lau Tsz Hin Alexander, Garg Anubhav, Popovic Marko M, Kertes Peter J, Muni Rajeev H
From the Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada (Lau); Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Garg); Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (Popovic, Kertes, Muni); John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Kertes); Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada (Muni).
J Cataract Refract Surg. 2022 Dec 1;48(12):1462-1468. doi: 10.1097/j.jcrs.0000000000001046.
Scleral fixation and iris fixation are common intraocular lens (IOL) implantation techniques performed because of zonulopathy. There is a lack of consensus regarding their comparative efficacy and safety. This study aims to compare the efficacy and safety outcomes after scleral-fixated (SF) vs iris-fixated (IF) IOL implantation or fixation in adults. A systematic literature search was conducted on Ovid MEDLINE, Embase, and Cochrane CENTRAL from 2005 to 2020. 785 eyes from 2 randomized controlled trials and 9 nonrandomized studies were included. There was no significant difference in the mean corrected distance visual acuity at the final follow-up ( P = .52) or absolute change in spherical equivalent ( P = .88) between SF IOL and IF IOL implantation. The incidence of vitreous hemorrhage was significantly higher in the SF IOL group (risk ratio = 3.66, 95% CI, 1.16-11.55, P = .03). There were no differences in visual acuity and refractive outcomes between SF IOL and IF IOL implantation or fixation. Trade-offs in complications exist between the 2 techniques.
巩膜固定和虹膜固定是由于悬韧带病变而进行的常见人工晶状体（IOL）植入技术。关于它们的相对疗效和安全性，目前尚无共识。本研究旨在比较成人巩膜固定（SF）与虹膜固定（IF）人工晶状体植入或固定后的疗效和安全性结果。对2005年至2020年期间的Ovid MEDLINE、Embase和Cochrane CENTRAL进行了系统的文献检索。纳入了来自2项随机对照试验和9项非随机研究的785只眼。SF人工晶状体植入与IF人工晶状体植入在最终随访时的平均矫正远视力（P = 0.52）或等效球镜绝对变化（P = 0.88）方面无显著差异。SF人工晶状体组玻璃体积血的发生率显著更高（风险比 = 3.66，95%CI，1.16 - 11.55，P = 0.03）。SF人工晶状体植入与IF人工晶状体植入或固定在视力和屈光结果方面无差异。这两种技术在并发症方面存在权衡。
