Intraocular lens dislocation in pseudoexfoliation: a systematic review and meta-analysis.

Abstract

To evaluate the impact of pseudoexfoliation syndrome on intraocular lens (IOL) dislocation after phacoemulsification cataract surgery and explore possible associations related to surgical technique. We systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and Lilacs databases and grey literature sources and identified (on March 1, 2016) 14 cohort and case-control studies comparing IOL dislocation in patients with and without pseudoexfoliation syndrome who had undergone phacoemulsification. Study quality was assessed using the STROBE scale. An inverse-variance fixed-effects model was used to calculate weighted odds ratios (ORs) and 95% confidence intervals (CI). The pooled analysis yielded an OR of 6.02 (95% CI: 3.7, 9.79) for IOL dislocation in patients with pseudoexfoliation, and similarly, high ORs were detected for both early and late (3months after surgery) dislocation (OR 5.26; 95% CI: 1.05; 26.32 versus OR 6.02; 95% CI: 3.67; 10.17). No significant associations were detected when the results were stratified by year, incision size or use of hooks or retractors. Patients with pseudoexfoliation syndrome have a high risk of late IOL dislocation after phacoemulsification cataract surgery, and this risk may be related to the use of large incisions and hooks or retractors.