Dataset Information

The efficacy of accommodative versus monofocal intraocular lenses for cataract patients: A systematic review and meta-analysis.

ABSTRACT:

Introduction

We performed a systematic review and meta-analysis to evaluate whether accommodative intraocular lenses (AC-IOLs) are superior for cataract patients compared with monofocal IOLs (MF-IOLs).

Methods

Pubmed, Embase, Cochrane library, CNKI, and Wanfang databases were searched through in August 2018 for AC-IOLs versus MF-IOLs in cataract patients. Studies were pooled under either fixed-effects model or random-effects model to calculate the relative risk (RR), weighted mean difference (WMD), or standard mean difference (SMD) and their corresponding 95% confidence interval (CI). Distance-corrected near visual acuity (DCNVA) was chosen as the primary outcome. The secondary outcomes were corrected distant visual acuity (CDVA), pilocarpine-induced IOL shift, contrast sensitivity, and spectacle independence.

Results

Seventeen studies, involving a total of 1764 eyes, were included. Our results revealed that AC-IOLs improved DCNVA (SMD?=?-1.84, 95% CI?=?-2.56 to -1.11) and were associated with significantly greater anterior lens shift than MF-IOLs (WMD?=?-0.30, 95% CI?=?-0.37 to -0.23). Furthermore, spectacle independence was significantly better with AC-IOLs than with MF-IOLs (RR?=?3.07, 95% CI?=?1.06-8.89). However, there was no significant difference in CDVA and contrast sensitivity between the 2 groups.

Conclusion

Our study confirmed that AC-IOLs can provide cataract patients with DCNVA and result in more high levels of spectacle independence than MF-IOLs. Further studies with larger data set and well-designed models are required to validate our findings.

SUBMITTER: Zhou H

PROVIDER: S-EPMC6200466 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The efficacy of accommodative versus monofocal intraocular lenses for cataract patients: A systematic review and meta-analysis.

Zhou Hongwei H Zhu Chongyan C Xu Wenya W Zhou Fang F

Medicine 20181001 40

<h4>Introduction</h4>We performed a systematic review and meta-analysis to evaluate whether accommodative intraocular lenses (AC-IOLs) are superior for cataract patients compared with monofocal IOLs (MF-IOLs).<h4>Methods</h4>Pubmed, Embase, Cochrane library, CNKI, and Wanfang databases were searched through in August 2018 for AC-IOLs versus MF-IOLs in cataract patients. Studies were pooled under either fixed-effects model or random-effects model to calculate the relative risk (RR), weighted mean ...[more]

PMID: 30290663

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Project description:Using an analytical approach of paraxial optics, we evaluated the magnification of a model eye implanted with single-element (1E) and dual-element (2E) translating-optics accommodative intraocular lenses (AIOL) with an objective of understanding key control parameters relevant to their design. Potential clinical implications of the results arising from pseudophakic accommodation were also considered.Lateral and angular magnifications in a pseudophakic model eye were analyzed using the matrix method of paraxial optics. The effects of key control parameters such as direction (forward or backward) and distance (0 to 2 mm) of translation, power combinations of the 2E-AIOL elements (front element power range +20.0 D to +40.0 D), and amplitudes of accommodation (0 to 4 D) were tested. Relative magnification, defined as the ratio of the retinal image size of the accommodated eye to that of unaccommodated phakic (rLM(1)) or pseudophakic (rLM(2)) model eyes, was computed to determine how retinal image size changes with pseudophakic accommodation.Both lateral and angular magnifications increased with increased power of the front element in 2E-AIOL and amplitude of accommodation. For a 2E-AIOL with front element power of +35 D, rLM(1) and rLM(2) increased by 17.0% and 16.3%, respectively, per millimetre of forward translation of the element, compared to the magnification at distance focus (unaccommodated). These changes correspond to a change of 9.4% and 6.5% per dioptre of accommodation, respectively. Angular magnification also increased with pseudophakic accommodation. 1E-AIOLs produced consistently less magnification than 2E-AIOLs. Relative retinal image size decreased at a rate of 0.25% with each dioptre of accommodation in the phakic model eye. The position of the image space nodal point shifted away from the retina (towards the cornea) with both phakic and pseudophakic accommodation.Power of the mobile element, and amount and direction of the translation (or the achieved accommodative amplitude) are important parameters in determining the magnifications of the AIOLs. The results highlight the need for caution in the prescribing of AIOL. Aniso-accommodation or inter-ocular differences in AIOL designs (or relative to the natural lens of the contralateral eye) may introduce dynamic aniseikonia and consequent impaired binocular vision. Nevertheless, some designs, offering greater increases in magnification on accommodation, may provide enhanced near vision depending on patient needs.

Dataset Information

The efficacy of accommodative versus monofocal intraocular lenses for cataract patients: A systematic review and meta-analysis.

Introduction

Methods

Results

Conclusion

Publications

The efficacy of accommodative versus monofocal intraocular lenses for cataract patients: A systematic review and meta-analysis.

Similar Datasets

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