The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: A systematic review and meta-analysis

• Published in: PloS one 2019-04, Vol.14 (4), p.e0214684-e0214684
• Main Authors: Zhang, Shuo, Wang, Jiaxing, Li, Ying, Liu, Ye, He, Li, Xia, Xiaobo
• Format: Article
• Language: English
• Subjects: Age; Analysis; Aphakia, Postcataract - epidemiology; Aphakia, Postcataract - surgery; Autism; Biology and Life Sciences; Capsule Opacification - epidemiology; Capsule Opacification - etiology; Capsule Opacification - prevention & control; Cataract - congenital; Cataract - epidemiology; Cataract extraction; Cataract Extraction - adverse effects; Cataract Extraction - statistics & numerical data; Cataracts; Congenital diseases; Contact lenses; Data processing; Engineering and Technology; Eye; Eye diseases; Eye surgery; Genetic disorders; Glaucoma; Glaucoma - epidemiology; Glaucoma - etiology; Glaucoma - prevention & control; Health aspects; Humans; Implantation; Incidence; Infant; Infant, Newborn; Intraocular lenses; Lens Implantation, Intraocular; Lenses, Intraocular - adverse effects; Lenses, Intraocular - statistics & numerical data; Medicine and Health Sciences; Meta-analysis; Online databases; Patients; Pediatrics; Physical Sciences; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Research and Analysis Methods; Risk; Risk Factors; Rubella; Surgery; Systematic review; Ying Li
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0214684

This meta-analysis aims to evaluate the incidence of secondary glaucoma in patients under the age of 2 years who underwent congenital cataract surgery with or without primary intraocular lens (IOL) implantation. An electronic literature search was performed in Medline, EMBASE, and Web of Science databases to retrieve studies between January 2011 and November 2018. Patients with congenital cataract who did primary IOL implantation, aphakia, or secondary IOL implantation followed by receiving extraction surgery were included in this study. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. Long-term incidences of secondary glaucoma, which developed at least one year after cataract surgery, were considered and discussed as clinical outcomes in each cohort. The pooled data were analyzed according to a random effects model. Eight publications involving 892 eyes were included in the current meta-analysis. In the general population of eyes with congenital cataract, the long-term incidence of secondary glaucoma was lower (P = 0.06) in eyes with primary IOL (9.5%) than in eyes without primary IOL (15.1%), including aphakia and secondary IOL. The pooled risk ratio (RR) favors primary IOL implantation in all patients (RR = 0.63). For bilateral congenital cataract, the incidence was 6.7% in eyes with primary IOL implantation, which is significantly lower than the 16.7% in eyes with aphakia and secondary IOL implantation (P