The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #phakic-intraocular-lenses #photosensitizing-agents #keratoconus #riboflavin

The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis

Fard et al., 2023 | Int Ophthalmol | Meta Analysis

Citation

Fard Ali Mahdavi, Patel Sangita P, Nader Nader D. The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis. Int Ophthalmol. 2023-Nov;43(11):4383-4393. doi:10.1007/s10792-023-02813-z

Abstract

PURPOSE: To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in keratoconus. METHODS: Data extracted from the publications meeting the selection. The outcome parameters included mean pre- and post-operative uncorrected distance visual acuity, corrected distance visual acuity (CDVA), sphere and cylinder of refraction and complications. Available data analyzed with Cochrane Review Manager. RESULTS: A total of 23 studies including 464 eyes were included. All the parameters showed significant improvement in all subgroups other than CDVA in ACPIOL + CXL subgroup and cylinder in PIOL + CXL subgroups. There was not a significant difference between PCPIOL and ACPIOL in the outcomes, exception was more improvement of CDVA in "ACPIOL only" than" PCPIOL only" subgroup. CONCLUSION: Both PCPIOLs and ACPIOLs are comparably safe and efficient options in management of KCN and their efficacy significantly improves when combined with CXL/ICRS.

Key Findings

A total of 23 studies including 464 eyes were included. All the parameters showed significant improvement in all subgroups other than CDVA in ACPIOL + CXL subgroup and cylinder in PIOL + CXL subgroups. There was not a significant difference between PCPIOL and ACPIOL in the outcomes, exception was more improvement of CDVA in "ACPIOL only" than" PCPIOL only" subgroup.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 23
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Phakic Intraocular Lenses
  • Photosensitizing Agents
  • Keratoconus
  • Riboflavin
  • Collagen
  • Corneal Topography
  • Cross-Linking Reagents
  • Corneal Stroma

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09