{
  "abstract": "Purpose To compare the outcomes of scleral-fixated intraocular lenses (SFIOLs) in the paediatric population. We included sutureless scleral-fixated intraocular lenses (SLSFIOLs), glued scleral-fixated intraocular lenses (GSFIOLs) and sutured scleral-fixated intraocular lenses (SSFIOLs) using polypropylene and Gore-Tex sutures.Methods A systematic review and meta-analysis were performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search was performed to include studies from 1999 to 2023. We included 1–18-year-old studies. The analysis was based on fixed and random-effect models. Primary outcomes included visual acuity, refraction and intraocular pressure (IOP). Secondary outcomes were lens tilt and extrusion of suture material.Results 33 studies (1531 eyes) were included (GSFIOLs n=75, SLSFIOLs n=162, SSFIOLs n=1294 (Gore-Tex n=30 and polypropylene n=1264)). Vision improved from preoperative (mean 0.75±0.50 SD) to postoperative (mean 0.39±0.19 SD) logarithm of the minimal angle of resolution. The mean spherical equivalent was 0.59±0.91. Transient high IOP post-OP was highest among polypropylene SSFIOLs, 8.1%. Polypropylene SSFIOLs had glaucoma in 0.31% and corneal decompensation in 0.15%. A suture break or erosion was reported in 1.19%. None of the other groups developed glaucoma or corneal decompensation. Suture erosion was not reported in Gore-Tex SSFIOLs. GSFIOLs had a 5.3% reoperation rate, mostly for IOL repositioning.Conclusion All types of scleral lens fixation showed improvement in initial outcomes. SLSFIOLs and Gore-Tex SSFIOLs have low complication rates.",
  "authors": [
    {
      "affiliations": [
        "Pediatric Ophthalmology Division, Pediatric Surgery Department, King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia",
        "King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"
      ],
      "name": "Taghreedl Alnajjar"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, UK",
        "King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia"
      ],
      "name": "Abdulmalik Alsaif"
    },
    {
      "affiliations": [
        "King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia",
        "Ophthalmology Department, Anterior Segment, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia",
        "King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"
      ],
      "name": "Tariq Aldebasi"
    },
    {
      "affiliations": [
        "Umm Al-Qura University, Makkah, Saudi Arabia"
      ],
      "name": "Shaimaa Alnajjar"
    },
    {
      "affiliations": [
        "Department of Ophthalmology and Visual Sciences, McGill University Health Centre, Montreal, Quebec, Canada"
      ],
      "name": "Mohammad Karam"
    },
    {
      "affiliations": [
        "Department of Ophthalmology and Visual Sciences, McGill University Health Centre, Montreal, Quebec, Canada"
      ],
      "name": "Moath Baeshen"
    },
    {
      "affiliations": [
        "Pediatric Ophthalmology Division, Pediatric Surgery Department, King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia",
        "King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia",
        "King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"
      ],
      "name": "Shatha Alfreihi"
    }
  ],
  "title": "Scleral-fixated intraocular lens in children: a meta-analysis and systematic review",
  "uid": "6686dbb1-ec40-52da-8543-8684ae8ea5b2"
}