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Systematic review
Retinal detachment incidence in refractive lens exchange versus cataract surgery: uncommon versus rare – systematic review and meta-analysis
  1. Maria Laura Passaro1,2,
  2. Deniz Kilic3,
  3. Gianni Virgili4,5,
  4. Vito Romano6,
  5. Ersilia Lucenteforte7,
  6. Burkhard Dick8,
  7. Suphi Taneri8,9
  1. 1 Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
  2. 2 Department of Medicine and Health Sciences "V.Tiberio", University of Molise, Campobasso, Italy
  3. 3 Ophthalmology, Dunyagoz Hospital, Izmir, Turkey
  4. 4 AOU Careggi, Department of Neurociences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Firenze, Florence, Italy
  5. 5 Opthalmology, IRCCS-Fondazione Bietti, Rome, Italy
  6. 6 Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
  7. 7 Department of Statistics, Computer Sciences and Applications "G. Parenti", University of Florence, Firenze, Italy
  8. 8 University eye clinic, Ruhr-University Bochum, Bochum, Germany
  9. 9 Augenzentrum am St. Franziskus Hospital, Zentrum für Refraktive Chirurgie, Muenster, Germany
  1. Correspondence to Prof Dr Suphi Taneri; taneri{at}refraktives-zentrum.de

Abstract

Aims Refractive lens exchange (RLE) is becoming a popular refractive solution for patients ineligible for corneal surgeries or phakic intraocular lenses. However, concerns regarding retinal detachment (RD) risk persist.

Methods A systematic literature review and meta-analysis was performed in Medline and Scopus.

The final search was updated on 30 March 2024.

Results Of 2415 full-text screening reports, 40 studies met inclusion criteria, encompassing 8 592 380 eyes. This included 20 264 eyes that underwent RLE and 8 572 116 eyes that underwent cataract surgery. In the RLE surgery subgroup, the RD incidence for follow-up <12 months was 0.00016% (0.00000%; 0.00034%), for follow-up between 12 and 24 months was 0.0000% (0.0000%; 0.03102%), and for follow-up >24 months was 0.02312% (0.00984%; 0.03640%) (p<0.01). In the cataract surgery subgroup, the incidence for follow-up >24 months was 0.01244% (0.00655%; 0.01832%), and for missing follow-up was 0.00429% (0.00221%; 0.00637%).

Conclusions We found that the incidence of RD after RLE was approximately double that observed after cataract surgery with at least 24 months (median 4 years) follow-up. Thus, RD may be classified as rare complication after cataract surgery (1/1000) and an uncommon complication after RLE (1/500). It must be noted that the heterogeneity of the subgroups after RLE was low. While some limitations, such as the lack of long-term follow-up in certain studies and incomplete reporting of factors like axial length or PVD status, may slightly influence the interpretation, these findings provide valuable insights. Acknowledging the inherent uncertainty in interpreting these results, additional studies are recommended.

PROSPERO registration number CRD42023431420.

  • Ophthalmologic Surgical Procedures
  • Risk Factors

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/bjo-2024-326592

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors VR, GV, BD and ST were responsible for conception and design. Literature search and data were collected by DK and MLP. Data interpretation and analysis were performed by DK, MLP, VR, GV and EL. MLP and DK wrote the manuscript. Critical revision of the manuscript was performed by EL, VR, ST, BD and GV. ST was responsible for funding. VR, GV and ST had supervision. All authors gave final revision and approval of submission. ST is the guarantor.

    • Funding Supported by Systematic Review Award of the European Society of Cataract & Refractive Surgeons (ESCRS).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.