Cataract and glaucoma surgery in microphthalmic, nanophthalmic, and high hyperopic eyes: a systematic review and meta-analysis.
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.
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.
surgery lowered nearsightedness sharply, on average, in these very small eyes
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.
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%).
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.
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.