Meta-analysis of the outcome of stability of intraocular lens with capsular tension ring

doi:10.3877/cma.j.issn.2095-2007.2020.03.004

Abstract

Abstract:

Objective

The aim of this study was to systematically evaluate the stability outcome of intraocular lens (IOL) with and without capsular tension ring (CTR).

Methods

A literature search was implemented in CNKI, Wanfang Data, VIP Data, PubMed, Medline and Cochrane Library, related literatures were collected. Using the evaluation method of Cochrane system, two reviewers independently performed literature search, screening, quality evaluation, and data extraction. The data including the degrees of postoperative rotation, uncorrected visual acuity (UCVA) and residual astigmatism were analyzed. The mean difference (MD) and a confidence interval (CI) of 95% were used to describe the effect sizes of continuous data. Heterogeneity was examined by Q test and I² statistics. When P<0.05 or I²>50% was examined using a random effects model. Otherwise, the fixed effects model was performed.

Results

In each database, 1253 literatures were retrieved. After excluding the repetitive literatures, the literatures with inconsistent contents or incomplete main outcome indicators, the literatures without randomized controlled trials (RCT) research and the literatures with data that cannot be extracted, there are 4 literatures included in this study. Among of them, there were 153 eyes with CTR and 156 eyes without CTR. Meta-analysis results showed that with CTR showed statistically relevant difference in the overall effect of maintaining the stability of IOL using the random effects model (MD=-0.81, 95%CI: -1.46~-0.15, P<0.05). There were showed no significant difference between the UCVA and whether or not using CTR (MD=0.02, 95%CI: -0.01~0.05, P>0.05); non-significant difference between residual astigmatism and whether or not using CTR (MD=-0.14; 95%CI: -0.33~0.05, P>0.05) .

Conclusions

CTR could reduce the degrees of postoperative IOL rotation. No significant differences were founded in posto-perative UCVA and residual astigmatism between with or without CTR groups. It is nessary to carry out more researches to demonstrate the great application of CTR on promoting the stability of Toric IOL.

Key words: Intermittent exotropia, Surgical treatment, Orthotopic rate, Factors

Hailong He, Chunyuan Zhou, Suo Guo, Ziyao Xia, Xinyu Zhao, Jinda Wang, Xiuhua Wan. Meta-analysis of the outcome of stability of intraocular lens with capsular tension ring[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2020, 10(03): 147-152.

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Figures/Tables 4

References 42

[1]	刘汝瑜，汤欣，宋慧，等. 囊袋张力环在晶状体超声乳化术中的应用[J]. 国际眼科杂志，2015, 15(3):451-453.
[2]	Mencucci R, Favuzza E, Guerra F, et al. Clinical outcomes and rotational stability of a 4-haptic toric intraocular lens in myopic eyes[J]. J Cataract Refract Surg, 2014, 40(9): 1479-1487.
[3]	Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range[J]. BMC Med Res Methodol, 2014, 14: 135.
[4]	Hahn U, Krummenauer F, Schmickler S, et al. Rotation of a toric intraocular lens with and without capsular tension ring: data from a multicenter non-inferiority randomized clinical trial (RCT)[J]. BMC Ophthalmol, 2019, 19(1): 143.
[5]	Rastogi A, Khanam S, Goel Y, et al. Comparative evaluation of rotational stability and visual outcome of toric intraocular lenses with and without a capsular tension ring[J]. Indian J Ophthalmol, 2018, 66(3): 411-415.
[6]	韩玉彤，陈彬川，朱光举，等. 超声生物显微镜观察囊袋张力环应用后人工晶状体的偏心量和倾斜度[J]. 眼科新进展，2017，37(6):562-565.
[7]	Lee DH, Shin SC, Joo CK. Effect of a capsular tension ring on intraocular lens decentration and tilting after cataract surgery[J]. J Cataract Refract Surg, 2002, 28(5): 843-846.
[8]	Hara T, Yamada Y. "Equator ring" for maintenance of the completely circular contour of the capsular bag equator after cataract removal[J]. Ophthalmic Surg, 1991, 22(6): 358-359.
[9]	Nagamoto T, Bissen-Miyajima H. A ring to support the capsular bag after continuous curvilinear capsulorhexis[J]. J Cataract Refract Surg, 1994, 20(4): 417-420.
[10]	Dick HB. Closed foldable capsular rings[J]. J Cataract Refract Surg, 2005, 31(3): 467-471.
[11]	Rai G, Sahai A, Kumar PR. Outcome of capsular tension ring (CTR) implant in complicated cataracts[J]. J Clin Diagn Res, 2015, 9(12): NC05-NC07.
[12]	Guo L, Wang C, Yang X. A novel technique for the surgical management of intraocular lens-capsular bag-capsular tension ring complex dislocation[J]. Exp Ther Med, 2019, 17(4): 2785-2788.
[13]	Buttanri IB, Sevim MS, Esen D, et al. Modified capsular tension ring implantation in eyes with traumatic cataract and loss of zonular support[J]. J Cataract Refract Surg, 2012, 38(3): 431-436.
[14]	Miyoshi T, Fujie S, Yoshida H, et al. Effects of capsular tension ring on surgical outcomes of premium intraocular lens in patients with suspected zonular weakness[J]. PLoS One, 2020, 15(2): e0228999.
[15]	Oudjani N, Renault D, Courrier E, et al. Phacoemulsification and zonular weakness: contribution of the capsular tension ring with a thread[J]. Clin Ophthalmol, 2019, 13: 2301-2304.
[16]	Tribus C, Alge CS, Haritoglou C, et al. Indications and clinical outcome of capsular tension ring (CTR) implantation: A review of 9528 cataract surgeries[J]. Clin Ophthalmology, 2007, 1(1): 65-69.
[17]	Luft N, Kreutzer TC, Dirisamer M, et al. Evaluation of laser capsule polishing for prevention of posterior capsule opacification in a human ex vivo model[J]. J Cataract Refract Surg, 2015, 41(12): 2739-45.
[18]	Bao X, Hou M, Qin Y, et al. Effect of an MG132-sustained drug delivery capsular ring on the inhibition of posterior capsule opacification in a rabbit model[J]. J Ocul Pharmacol Ther, 2017, 33(2): 103-110.
[19]	Li B, Wang Y, Malvankar-Mehta MS, et al. Surgical indications, outcomes, and complications with the use of a modified capsular tension ring during cataract surgery[J]. J Cataract Refract Surg, 2016, 42(11): 1642-1648.
[20]	Halili I, Mutlu FM, Erdurman FC, et al. Influence of capsular tension ring on posterior capsule opacification in myopic eyes[J]. Indian J Ophthalmol, 2014, 62(3): 311-315.
[21]	Burger J, Kreutzer T, Alge CS, et al. Capsular tension ring-based in vitro capsule opacification model[J]. J Cataract Refract Surg, 2008, 34(7): 1167-1172.
[22]	Lei M, Peng Z, Dong Q, et al. A novel capsular tension ring as local sustained-release carrier for preventing posterior capsule opacification[J]. Biomaterials, 2016, 9: 148-156.
[23]	Yu JG, Zhong J, Mei ZM, et al. Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China[J]. BMC Ophthalmol, 2017, 17(1): 56-63.
[24]	王军，曹迎雪. 提高对白内障摘除手术中角膜散光矫正的认识和技术[J]．中华眼科杂志，2018，54(5):321-323.
[25]	王越，柯敏，郑恬，等. 2085例年龄相关性白内障患者白内障摘除术前角膜散光情况的调查[J]. 中华眼科杂志，2017，53(7):522-527.
[26]	刘洋，赵少贞，杨瑞波，等. 角膜缘松解切开术矫正白内障术前散光对角膜曲率的影响[J]．眼科新进展，2016，36(4):340-344.
[27]	陈威，周婧，杜君，等. 飞秒激光弧形角膜切开术对白内障合并角膜散光患者的矫正效果[J]. 眼科新进展，2019，39(12):1137-1140.
[28]	Lai KR, Zhang XB, Yu YH, et al. Comparative clinical outcomes of Tecnistoric IOL implantation in femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery[J]. Int J Ophthalmol, 2020, 13(1): 49-53.
[29]	Lake JC, Victor G, Clare G, et al. Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification[J]. Cochrane Database Syst Rev, 2019, 12: CD012801.
[30]	Shimizu K, Misawa A, Suzuki Y. Toric intraocular lenses: Correcting astigmatism while controlling axis shift[J]. J Cataract Refract Surg, 1994, 20(5): 523-526.
[31]	Kessel L, Andresen J, Tendal B, et al. Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis[J]. Ophthalmol, 2016, 123(2): 275-286.
[32]	Li S, Li X, He S, et al. Early postoperative rotational stability and its related factors of a single-piece acrylic toric intraocular lens[J]. Eye (Lond), 2020, 34(3): 474-479.
[33]	Grabow HB. Early results with foldable toric IOL implantation[J]. Eur J Implant Refract Surg, 1994, 6: 177-178.
[34]	Novis C. Astigmatism and toric intraocular lenses[J]. Curr Opin Ophthalmol, 2000, 11(1): 47-50.
[35]	Felipe A, Artigas JM, Díez-Ajenjo A, et al. Residual astigmatism produced by toric intraocular lens rotation[J]. J Cataract Refract Surg, 2011, 37(10): 1895-1901.
[36]	Garzón N, Poyales F, de Zárate BO, et al. Evaluation of rotation and visual outcomes after implantation of monofocal and multifocal toric intraocular lenses[J]. J Refract Surg, 2015, 31(2): 90-97.
[37]	Zhu X, He W, Zhang K, et al. Factors influencing 1-year rotational stability of Acrys of Toric intraocular lenses[J]. Br J Ophthalmol, 2016, 100(2): 263-268.
[38]	Vokrojová M, Havlíĉková L, Brožková M, et al. Effect of capsular tension ring implantation on postoperative rotational stability of a toric intraocular len[J]. J Refract Surg, 2020, 36(3): 186-192.
[39]	Miyake T, Kamiya K, Amano R, et al. Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism[J]. J Cataract Refract Surg, 2014, 40(10): 1654-1660.
[40]	Varsits RM, Hirnschall N, Döller B, et al. Evaluation of an intraoperative toric intraocular lens alignment system using an image-guided system[J]. J Cataract Refract Surg, 2019, 45(9): 1234-1238.
[41]	Zhao Y, Li J, Yang K, et al. Combined special capsular tension ring and toric IOL implantation for management of astigmatism and high axial myopia with cataracts[J]. Semin Ophthalmol, 2018, 33(3): 389-394.
[42]	谭青青，廖萱，兰长骏，等. Toric人工晶状体与角膜切口矫正白内障低中度角膜散光比较的Meta分析[J]．中华眼科杂志，2019，55(7):522-530.

第一作者	发表年份	眼数(只)		旋转度(°)		未矫正视力		残余散光(D)
第一作者	发表年份	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环
Hahn^[4]	2019	89	90	2.07±2.10	1.92±1.82	0.96±0.09	0.93±0.15	0.59±0.49	0.64±0.48
Rastogi^[5]	2018	25	25	1.85±1.72	4.02±2.04	0.63±0.11	0.62±0.10	0.62±0.32	0.86±0.29
韩玉彤^[6]	2017	19	21	0.21±0.74	1.24±0.97	0.62±0.28	0.54±0.32
Lee^[7]	2002	20	20	2.47±0.40	3.06±0.56	0.71±0.25	0.74±0.30

第一作者	发表年份	眼数(只)		旋转度(°)		未矫正视力		残余散光(D)
第一作者	发表年份	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环	囊袋张力环	非囊袋张力环
Hahn^[4]	2019	89	90	2.07±2.10	1.92±1.82	0.96±0.09	0.93±0.15	0.59±0.49	0.64±0.48
Rastogi^[5]	2018	25	25	1.85±1.72	4.02±2.04	0.63±0.11	0.62±0.10	0.62±0.32	0.86±0.29
韩玉彤^[6]	2017	19	21	0.21±0.74	1.24±0.97	0.62±0.28	0.54±0.32
Lee^[7]	2002	20	20	2.47±0.40	3.06±0.56	0.71±0.25	0.74±0.30

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