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Advisability of primary intraocular lens implantation for infants under 2: A systematic review and meta-analysis
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  • Shanshan Jin,
  • Jing Shang Zhang,
  • Jin Da Wang,
  • Yusufu Mayinuer,
  • Kai Cao,
  • Guyu Zhu,
  • Hailong He,
  • Xiu Wan
Shanshan Jin
Beijing Institute of Ophthalmology
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Jing Shang Zhang
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Jin Da Wang
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Yusufu Mayinuer
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Kai Cao
Beijing Institute of Ophthalmology
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Guyu Zhu
Beijing Institute of Ophthalmology
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Hailong He
Beijing Institute of Ophthalmology
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Xiu Wan
Beijing Institute of Ophthalmology
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Abstract

Purposes: The present meta-analysis compared the postoperative visual performance of primary intraocular lens (IOL) implantation and primary aphakia in cataract infants. Methods: We performed a systematic literature search in PubMed, EMBASE and Science Direct. Postoperative visual acuity (VA) and complications were extracted and pooled. Results: Four randomized controlled trails (RCTs) and seven retrospective studies were included. The postoperative VA in primary IOL group was better than that in primary aphakia group [MD=-0.12, 95% CI: (-0.19, -0.05), p=0.91]. There was no significant difference in the incidence of glaucoma, retinal detachment and nystagmus between primary IOL group and primary aphakia group [OR=1.27, 95% CI: (0.79, 2.05), p=0.84 for glaucoma; OR=0.49, 95%CI: (0.07, 3.30), p=0.34 for retinal detachment;; OR=1.11, 95%CI: (0.62, 1.98), p=0.73 for nystagmus]. Analysis of unilateral subgroup indicated there were fewer infants with strabismus in primary IOL group compared with primary aphakia group [OR=0.40, 95% CI: (0.21, 0.79), p=0.46]. The primary IOL group needed more visual axis opacification (VAO) clearing than primary aphakia group [OR=9.33, 95%CI: (5.21, 16.73), p=0.27]. Conclusion: Primary IOL implantation provided more visual benefits. IOL implantation may decrease the incidence of strabismus in comparison with primary aphakia in unilateral subgroup. However, these advantages could be offset by a higher VAO clearing surgery.

Peer review status:ACCEPTED

08 Sep 2020Submitted to International Journal of Clinical Practice
08 Sep 2020Submission Checks Completed
08 Sep 2020Assigned to Editor
17 Sep 2020Reviewer(s) Assigned
26 Sep 2020Review(s) Completed, Editorial Evaluation Pending
16 Nov 20201st Revision Received
18 Nov 2020Submission Checks Completed
18 Nov 2020Assigned to Editor
18 Nov 2020Reviewer(s) Assigned
30 Nov 2020Review(s) Completed, Editorial Evaluation Pending
18 Dec 20202nd Revision Received
18 Dec 2020Assigned to Editor
18 Dec 2020Submission Checks Completed
18 Dec 2020Reviewer(s) Assigned
02 Jan 2021Review(s) Completed, Editorial Evaluation Pending
09 Mar 2021Editorial Decision: Accept