Purposes: The present meta-analysis compared the postoperative visual performance of primary intraocular lens (IOL) implantation and primary aphakia in cataract infants. Methods: We performed a systematic literature search in PubMed, EMBASE and Science Direct. Postoperative visual acuity (VA) and complications were extracted and pooled. Results: Four randomized controlled trails (RCTs) and seven retrospective studies were included. The postoperative VA in primary IOL group was better than that in primary aphakia group [MD=-0.12, 95% CI: (-0.19, -0.05), p=0.91]. There was no significant difference in the incidence of glaucoma, retinal detachment and nystagmus between primary IOL group and primary aphakia group [OR=1.27, 95% CI: (0.79, 2.05), p=0.84 for glaucoma; OR=0.49, 95%CI: (0.07, 3.30), p=0.34 for retinal detachment;; OR=1.11, 95%CI: (0.62, 1.98), p=0.73 for nystagmus]. Analysis of unilateral subgroup indicated there were fewer infants with strabismus in primary IOL group compared with primary aphakia group [OR=0.40, 95% CI: (0.21, 0.79), p=0.46]. The primary IOL group needed more visual axis opacification (VAO) clearing than primary aphakia group [OR=9.33, 95%CI: (5.21, 16.73), p=0.27]. Conclusion: Primary IOL implantation provided more visual benefits. IOL implantation may decrease the incidence of strabismus in comparison with primary aphakia in unilateral subgroup. However, these advantages could be offset by a higher VAO clearing surgery.

PURPOSE: To observe the effect of phacoemulsification and intraocular lens (IOL) implantation with or without lens capsular tension ring (CTR) on retinitis pigmentosa (RP) combined with cataract patients. DESIGN: Retrospective cases series study. METHODS: 63cases (84 eyes) of RP with cataract were collected including 30 males and 33 females. Phacoemulsification with 3.0mm clear corneal incision was performed in all the patients. IOL+CTR implantation was performed in 44 eyes, and only IOL implantation was performed in 40 eyes. All cases were followed up at 1 week and 1, 3, 6 months after the surgery to compare the best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial cell count and complications before and after the surgery. RESULTS: all surgery were successfully completed by the same physician, and IOL and CTR were all implanted in capsule without complications. The BCVA at 6 months after surgery was 0.91±0.88 LogMAR. It improved a little compared with the BCVA(1.3±0.7LogMAR) before surgery and there was a signifcant difference in statistic(P=0.003). Four cases of capsule contraction syndrome(CCS) occurred in no CTR implantation group and there was no CCS in CTR group. There was signifcant difference in statistic about the incidence of CCS between two groups(P=0.047). CONCLUSIONS: Phacoemulsification for RP combined with cataract is safe and reliable, and CTR implantation is helpful to reduce the complications caused by capsule contraction.