Effect of image-guided systems in phacoemulsification with intraocular lens (IOL) implantation: a systematic review and meta-analysis

Abstract

Purpose

To explore the effect of image-guided systems in phacoemulsification with intraocular lens (IOL) implantation.

Methods

We searched Pubmed, Embase and China National Knowledge Infrastructure (inception to January 20, 2021). Two researchers extracted data and assessed paper quality independently. Uncorrected distance visual acuity (UDVA) before and after surgery, best corrected visual acuity (BCVA) before and after surgery, preoperative cylinder, postoperative residual refractive cylinder, postoperative corneal cylinder, IOL misalignment, and intraocular pressure (IOP) were compared.

Results

We included 14 studies with 885 cataract eyes. All data were performed using Review Manager 5.3 (RevMan 5.3) (https://revman.cochrane.org/). Cases of all preoperative outcomes showed no significant difference between image-guided group and manual group. There was no significant difference in postoperative UDVA (Standard mean difference (SMD: −0.11, 95% CI: −0.32 to 0.11, I² = 59%, p = 0.33)), BCVA (SMD: 0.03, 95% CI: −0.12 to 0.18, I² = 36%, p = 0.72), corneal cylinder (Weighted mean difference WMD: 0.13, 95% CI: −0.06 to −0.32, I² = 0%, p = 0.17), IOP (WMD: −0.37, 95% CI: −1.36 to −0.62, I² = 9%, p = 0.46) between two groups. There was less residual refractive cylinder in image-guided group than in manual group (WMD: −0.20, 95% CI: −0.26 to −0.14, I² = 59%, p＜0.00001). It is more accurate in IOL alignment when combined with image-guided systems (WMD: −1.20, 95% CI: −1.43 to −0.96, I² = 14%, p < 0.00001).

Conclusion

Image-guided systems can improve the effect in phacoemulsification with intraocular lens (IOL) implantation.

Keywords:

• Cataract
• image-guided
• IOL implantation
• systematic review

Author contributions

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure statement

Yang Su, Min Fu, Yifan Chen, Rui Qiao and Guo-Guo Yi declare no personal, financial, commercial, or academic conflicts of interest, and none of the authors have a financial or proprietary interest in a product, method, or material in this paper.

Data availability statement

The datasets generated during and/or analyses during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by Natural Science Foundation of Beijing Municipality (Grant No. 7192222) and National Natural Science Foundation of China (Grant No. 82072352).