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The efficacy of accommodative versus monofocal intraocular lenses for cataract patients A systematic review and meta-analysis
Stockholm University, Faculty of Social Sciences, Department of Statistics. Capital University of Economics and Business, China.
Number of Authors: 42018 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 97, no 40, article id e12693Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2018. Vol. 97, no 40, article id e12693
Keywords [en]
accommodative intraocular lenses, cataract, meta-analysis, monofocal intraocular lenses, systematic review
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:su:diva-163730DOI: 10.1097/MD.0000000000012693ISI: 000452230500077PubMedID: 30290663OAI: oai:DiVA.org:su-163730DiVA, id: diva2:1277189
Available from: 2019-01-09 Created: 2019-01-09 Last updated: 2019-01-09Bibliographically approved

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