Scleral Fixation of Carlevale Intraocular Lens: A Systematic Review And Meta-Analysis

Abstract

Purpose: The mean change in best-corrected visual acuity (BCVA), intraocular pressure (IOP), and endothelial cell counts (ECD) 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 (SSF) 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, IOP, and ECD 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 thirteen 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% CI: 0.30 to 0.46, p <0.001; heterogeneity (I2) =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 six months: 0.34, 95% CI: 0.23 to 0.45, I2 = 58.32%, WMD up to twenty-four months: 0.42, 95% CI: 0.34 to 0.51, I2 = 38.08 %). In the meta-analysis of sixteen studies involving 608 eyes, the pooled incidence rate of postoperative complications was equal to 0.22 (CI: 0.13–0.32, I2 = 84.87, p ≤ 0.001). Conclusions: Carlevale IOL implantation represents a reliable method of restoring vision in eyes with missing capsular or zonular support.