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

Zhang, Shuo; Wang, Jiaxing; Li, Ying; Liu, Ye; Xia, Xiaobo

doi:10.1371/journal.pone.0214684

Cited by 34 publications

(33 citation statements)

References 34 publications

(36 reference statements)

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“…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.…”

Section: Photoscreening and Corrections For Photoscreener Resultsmentioning

confidence: 90%

School-based epidemiology study of myopia in Tianjin, China

et al. 2020

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Purpose To study the epidemiology of myopia in school-aged children in Tianjin and the relationship between visual acuity-based screening and refraction-based screening. Method This school-based prospective cohort study was performed on children from 42 elementary schools and 17 middle schools in Tianjin, China. Totally 14,551 children, ages ranging from 5 to 16 years, were included in this study. Uncorrected visual acuity (UCVA) was determined by logarithmic tumbling E chart. Non-cycloplegic photorefraction was examined by the Spot (v2.1.4) photoscreener. The relationship between the UCVA and refractive error was investigated for different age groups. Results The overall prevalence of myopia at this school based screen is 78.2%, ranged from 10% at age of 5 to 95% at age of 16. The most dramatic increase in prevalence is from age of 6 (14.8%) to age of 7 (38.5%). The overall prevalence of high myopia is 2.5%. UCVA is found corresponding to spherical equivalent refraction (SER) in a manner of normal distribution and is significantly affected by age. When using UCVA to estimate the prevalence of myopia, the overall sensitivity and specificity are 0.824 and 0.820, respectively. Age-dependent optimal cutoff points and 95% confident intervals of such estimation are reported. Conclusions Myopia is heavily affecting school-aged children in Tianjin, China. The refraction screening is preferable for myopia screening, whereas the UCVA screening results need to be interpreted in an age-dependent manner for myopia estimation.

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Section: Photoscreening and Corrections For Photoscreener Resultsmentioning

confidence: 90%

School-based epidemiology study of myopia in Tianjin, China

et al. 2020

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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To evaluate outcomes of bilateral cataract surgery in infants 1 to 7 months of age performed by Infant Aphakia Treatment Study (IATS) investigators during IATS recruitment and to compare them with IATS unilateral outcomes.Design: Retrospective case series review at 10 IATS sites.Participants: The Toddler Aphakia and Pseudophakia Study (TAPS) is a registry of children treated by surgeons who participated in the IATS.Methods: Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement during IATS enrollment years 2004 through 2010.Main Outcome Measures: Visual acuity (VA), strabismus, adverse events (AEs), and reoperations.Results: One hundred seventy-eight eyes (96 children) were identified with a median age of 2.5 months (range, 1e7 months) at the time of cataract surgery. Forty-two eyes (24%) received primary IOL implantation. Median VA of the better-seeing eye at final study visit closest to 5 years of age with optotype VA testing was 0.35 logarithm of the minimum angle of resolution (logMAR; optotype equivalent, 20/45; range, 0.00e1.18 logMAR) in both aphakic and pseudophakic children. Corrected VA was excellent (<20/40) in 29% of better-seeing eyes, 15% of worse-seeing eyes. One percent showed poor acuity (20/200) in the better-seeing eye, 12% in the worse-seeing eye. Younger age at surgery and smaller (<9.5 mm) corneal diameter at surgery conferred an increased risk for glaucoma or glaucoma suspect designation (younger age: odds ratio [OR], 1.44; P ¼ 0.037; and smaller cornea: OR, 3.95; P ¼ 0.045). Adverse events also were associated with these 2 variables on multivariate analysis (younger age: OR, 1.36; P ¼ 0.023; and smaller cornea: OR, 4.78; P ¼ 0.057). Visual axis opacification was more common in pseudophakic (32%) than aphakic (8%) eyes (P ¼ 0.009). Unplanned intraocular reoperation occurred in 28% of first enrolled eyes (including glaucoma surgery in 10%).Conclusions: Visual acuity after bilateral cataract surgery in infants younger than 7 months is good, despite frequent systemic and ocular comorbidities. Although aphakia management did not affect VA outcome or AE incidence, IOL placement increased the risk of visual axis opacification. Adverse events and glaucoma correlated with a younger age at surgery and glaucoma correlated with the presence of microcornea. Ophthalmology 2020;127:501-510 ª 2019 by the American Academy of Ophthalmology Supplemental material available at www.aaojournal.org. MethodsThis study was approved by the institutional review board or ethics review board at all participating institutions (Mayo Clinic,

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Liu

Li²,

Jiu³

et al. 2019

Medicine

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Background:The aim of this meta-analysis is to compare the efficacy and safety of combined phacoemulsification (Phaco) with goniosynechialysis (GSL) to either Phaco or to Phaco combined with trabeculectomy or trabeculectomy alone in patients with angle closure glaucoma (ACG).Methods:Five main electronic databases were searched for the eligible studies. Intraocular pressure (IOP) decrease was set as the primary outcome, while anti-glaucomatous medication decrease, changes of anterior chamber depth (ACD), range of peripheral anterior synechia (PAS), and complication occurrence were the secondary outcomes. Standard mean difference (SMD) and relative risk (RR) were the size effects for continuous and binomial data, respectively. Either fixed-effects model or random-effects model was chosen to pool the data based on the heterogeneities.Results:A total of 7 eligible studies were included. The combined data showed the IOP decreased more significantly after Phaco-GSL than that after Phaco alone (SMD = –0.42,95%CI: –0.70 – 0.14, I2 = 17.6%, Z = 2.90, P = .004). However, there were no distinct differences regarding medication decrease (SMD = –0.25,95%CI: –0.70 – 0.21, I2 = 0%, Z = 1.06, P = 0.29), ACD, the range of PAS and complication occurrence rate when compared Phaco-GSL to Phaco. Moreover, Phaco-GSL was comparable to Phaco-trabeculectomy/trabeculectomy in decreasing IOP (SMD = –0.08, 95%CI = –0.32 – 0.15, I2 = 0%, Z = 0.70, P = .49).Conclusions:Phaco-GSL might be an optimal procedure to treat ACG with concomitant cataract due to its bleb-less nature, and its capacity for lowering IOP seems superior to Phaco alone and comparable to Phaco-trabeculectomy/trabeculectomy.

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

Cited by 34 publications

References 34 publications

School-based epidemiology study of myopia in Tianjin, China

School-based epidemiology study of myopia in Tianjin, China

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

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

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