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The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis

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Abstract

Purpose

To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in keratoconus.

Methods

Data extracted from the publications meeting the selection. The outcome parameters included mean pre- and post-operative uncorrected distance visual acuity, corrected distance visual acuity (CDVA), sphere and cylinder of refraction and complications. Available data analyzed with Cochrane Review Manager.

Results

A total of 23 studies including 464 eyes were included. All the parameters showed significant improvement in all subgroups other than CDVA in ACPIOL + CXL subgroup and cylinder in PIOL + CXL subgroups. There was not a significant difference between PCPIOL and ACPIOL in the outcomes, exception was more improvement of CDVA in “ACPIOL only” than” PCPIOL only” subgroup.

Conclusion

Both PCPIOLs and ACPIOLs are comparably safe and efficient options in management of KCN and their efficacy significantly improves when combined with CXL/ICRS.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Ali Mahdavi Fard & Sangita P. Patel

  2. Department of Ophthalmology, Doheny Eye Center of UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Ali Mahdavi Fard

  3. Research and Ophthalmology Services, Veterans Administration of Western New York Healthcare System, Buffalo, NY, USA

    Sangita P. Patel

  4. Department of Anesthesiology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Nader D. Nader

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  1. Ali Mahdavi Fard
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Ali Mahdavi Fard, Sangita P. Patel and Nader D. Nader. The first draft of the manuscript was written by Ali Mahdavi Fard and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Nader D. Nader.

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Fard, A.M., Patel, S.P. & Nader, N.D. The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis. Int Ophthalmol 43, 4383–4393 (2023). https://doi.org/10.1007/s10792-023-02813-z

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