Elgazzar Akram Fekry, Tharwat Ehab, Diab Sherein, Abdella Walid Shaban, Abdelaziz Ahmed, Elejla Sewar, Ahmed Mariam Mohamed, Kamel Mohamed Abdelmonem, Qobeia Esraa, Selim Ahmed Nabil, Abdelhameed Hazem Mohamed, Hassanein Mohamed, Gad Ashraf, El Gabbar Abdel Ghany Ali, Abdelkader Amr Mohammed Elsayed
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Int Ophthalmol. 2025 Jun 2;45(1):220. doi: 10.1007/s10792-025-03505-6.
To determine the efficacy of implantable Collamer lens (ICL) implantation after corneal collagen cross-linking in keratoconus.
We searched PubMed, Cochrane CENTRAL, SCOPUS, Web of Science, and Google Scholar from inception until October 2022. We included the relevant studies that assessed ICL implantation post-corneal collagen cross-linking in patients with keratoconus. The efficacy endpoints were corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), manifest refraction (sphere, cylinder, spherical equivalent), and keratometry.
Seven observational studies were eligible for this systematic review and meta-analysis. ICL implantation showed an improvement in UDVA, 6 months postoperative, with a mean change of - 1.27 log MAR (95% CI [- 1.63 to - 0.9]. However, there was a non-significant improvement in CDVA with a mean change of - 0.04 log MAR (95% CI [- 0.11 to 0.02]. A trend toward the improved sphere and spherical equivalent was observed for all eyes after the ICL implantation approach: mean change of 6.82 diopters (95% CI 3.24 to 10.4) for the sphere and 7.30 diopters (95% CI [4.18 to 10.43]) for the spherical equivalent. The refractive cylinder was not improved after ICL implantation 0.62 diopters (95% CI [- 0.53 to 1.77].
The ICL implantation approach appears to be effective for improving visual acuity in patients with keratoconus without adversely affecting corneal keratometry after crosslinking.
确定圆锥角膜患者角膜胶原交联术后植入可植入式Collamer晶状体（ICL）的疗效。
我们检索了从创刊至2022年10月的PubMed、Cochrane CENTRAL、SCOPUS、Web of Science和谷歌学术。我们纳入了评估圆锥角膜患者角膜胶原交联术后ICL植入的相关研究。疗效终点为矫正远视力（CDVA）、未矫正远视力（UDVA）、显验光（球镜、柱镜、等效球镜）和角膜曲率测量。
七项观察性研究符合本系统评价和荟萃分析的条件。ICL植入术后6个月时UDVA有所改善，平均变化为-1.27 log MAR（95%CI[-1.63至-0.9]）。然而，CDVA改善不显著，平均变化为-0.04 log MAR（95%CI[-0.11至0.02]）。ICL植入术后所有眼睛的球镜和等效球镜有改善趋势：球镜平均变化6.82屈光度（95%CI 3.24至10.4），等效球镜平均变化7.30屈光度（95%CI[4.18至10.43]）。ICL植入后柱镜屈光度未改善，为0.62屈光度（95%CI[-0.53至1.77]）。
ICL植入方法似乎对改善圆锥角膜患者的视力有效，且在交联后不会对角膜曲率测量产生不利影响。
