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New research · Ophthalmology
Frontiers in ophthalmology · 5d
Systematic reviewFrontiers in ophthalmology · 2026

Cataract and glaucoma surgery in microphthalmic, nanophthalmic, and high hyperopic eyes: a systematic review and meta-analysis.

Rebecca Zheng Li, Abdullah Virk, David Bulanov … Karen Allison
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OphthalmologySystematic review

Cataract surgery alone markedly reduced refractive error in nanophthalmic eyes.

Cataract and glaucoma surgery in microphthalmic, nanophthalmic, and high hyperopic eyes: a systematic review and meta-analysis.

Rebecca Zheng Li … Karen Allison
Frontiers in ophthalmology · 2026
Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a search was conducted across five databases (Cochrane, PubMed, Scopus, Ovid MEDLINE, and Embase via Ovid) for studies published between January 2010 and December 2024.

n = 1,110 eyes
Results

surgery lowered nearsightedness sharply, on average, in these very small eyes

MD by subgroup · 95% CI
null = 0
at medium-term follow-up and in high
-9.23
medium-term
-0.70
n a significant worsening in VA at
0.28
More results

Standalone phacoemulsification significantly improved visual acuity in nanophthalmic eyes at both short-term (MD = -0.66 logarithm of the minimum angle of resolution (logMAR); 95% CI: -1.30, -0.02; Q = 98.45, p < 0.001, I 2 = 97.0%) and medium-term (MD = -0.70 logMAR; 95% CI: -1.30, -0.09; Q = 97.14, p < 0.001, I 2 = 93.8%) follow-up with high heterogeneity in the effects.

More results

In contrast, phacoemulsification + filtering surgery resulted in a significant worsening in visual acuity at short-term follow-up for nanophthalmic eyes (MD = 0.28 logMAR; 95% CI: 0.21, 0.35; Q = 1.24, p = 0.27, I 2 = 19.4%).

“
Conclusion · 1 of 2

Surgical interventions in adults with nanophthalmos, microphthalmos, and high hyperopia were associated with meaningful improvements in refractive error, visual acuity, IOP, and anterior chamber depth, although outcomes varied by underlying diagnosis and procedure type.

Conclusion · 2 of 2

Standalone phacoemulsification consistently improved refractive and anatomical outcomes, particularly in nanophthalmos and high hyperopia, while combined procedures incorporating vitrectomy or filtering surgery achieved greater IOP reduction in eyes with concomitant glaucoma.

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