Meta-Analysis Study for the Best Surgical Techniques for Secondary Intraocular Lens Implantation in Complicated Cataract Surgeries

Abstract Background The most appropriate location to implant intraocular lenses (IOL) is the interior of the capsular bag, but in complicated cataract surgeries, procedures of secondary IOL implantation are associated with insufficiency or absence of this anatomic structure. In these cases, the IOL must be fixated at alternative sites of the eye globe, e.g., the iris or the sclera. Aim of the Work to compare different surgical IOL implantation techniques for best correction of aphakia, postoperative visual acuity, acquired astigmatism and least complications as corneal decompensation, glaucoma and angle support. Methodology This systematic review included a discussion of all available studies meeting the eligible criteria including: well conducted descriptive studies, cohort, articles, accepted manuscripts, clinical trials, analytic studies and the literature of reviews, technical notes. An extensive search of electronic literature located 291 studies; 160 duplicates were removed and 131 of which were eliminated after the title and abstract were reviewed. Results This study demonstrated a statistically significant change in the mean BCVA improvement in all techniques when comparing the baseline to one and three month follow up after operation, though with no statistically difference between the three techniques as A final corrected distance visual acuity of 6/12 or better was achieved in (65%) implanted with an AC-IFIOL, in (44.3%) with anRP-IFIOL, and (18.1%) with an SF-PCIOL(two studies only taken in consideration). At six month follow up all groups showed no significant difference in the BCVA compared to the baseline and along the follow up periods. There is no significant loss in mean ECD in all groups. Regarding IOP elevation it was more in scleral fixated and anterior chamber IOL than that in retropupillary IOL, and glaucoma was the second most common complication in secondary IOL implantation after anterior chamber reaction. Conclusion AC-IFIOL, RP-IFIOL, and SF-IFIOL were similar in visual efficacy and mean corneal endothelial cell loss. Although IOP elevation was significantly higher in the SF- PCIOL group than in the other groups, other rates of complications were similar between the groups.