Evidence map›Paper›PMID 40455349›Full record

SynthesisInternational ophthalmology2025

Efficacy of implantable Collamer lens after corneal cross-linking in patients with keratoconus: a systematic review and meta-analysis.

Akram Fekry Elgazzar, Ehab Tharwat, Sherein Diab, Walid Shaban Abdella, Ahmed Abdelaziz, Sewar Elejla, Mariam Mohamed Ahmed, Mohamed Abdelmonem Kamel, Esraa Qobeia, Ahmed Nabil Selim and 5 more

Abstract readSystematic ReviewMeta-Analysis
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In one paragraph

Synthesis in International ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Akram Fekry ElgazzarDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ehab TharwatDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt. ehabtharwat71@domazhermedicine.edu.eg.
Sherein DiabFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Walid Shaban AbdellaDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ahmed AbdelazizFaculty of Medicine, Al-Azhar University for Boys, Cairo, Egypt.
Sewar ElejlaFaculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Mariam Mohamed AhmedFaculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed Abdelmonem KamelFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Esraa QobeiaFaculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt.
Ahmed Nabil SelimFaculty of Medicine, Al-Azhar University, Assiut, Egypt.
Hazem Mohamed AbdelhameedDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Mohamed HassaneinDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ashraf GadDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Abdel Ghany Ali El GabbarDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Amr Mohammed Elsayed AbdelkaderDepartment of Ophthalmology, Faculty of Medicine, Mansura University, Mansura, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine the efficacy of implantable Collamer lens (ICL) implantation after corneal collagen cross-linking in keratoconus.

methodsWe searched PubMed, Cochrane CENTRAL, SCOPUS, Web of Science, and Google Scholar from inception until October 2022. We included the relevant studies that assessed ICL implantation post-corneal collagen cross-linking in patients with keratoconus. The efficacy endpoints were corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), manifest refraction (sphere, cylinder, spherical equivalent), and keratometry.

resultsSeven observational studies were eligible for this systematic review and meta-analysis. ICL implantation showed an improvement in UDVA, 6 months postoperative, with a mean change of - 1.27 log MAR (95% CI [- 1.63 to - 0.9]. However, there was a non-significant improvement in CDVA with a mean change of - 0.04 log MAR (95% CI [- 0.11 to 0.02]. A trend toward the improved sphere and spherical equivalent was observed for all eyes after the ICL implantation approach: mean change of 6.82 diopters (95% CI 3.24 to 10.4) for the sphere and 7.30 diopters (95% CI [4.18 to 10.43]) for the spherical equivalent. The refractive cylinder was not improved after ICL implantation 0.62 diopters (95% CI [- 0.53 to 1.77].

conclusionThe ICL implantation approach appears to be effective for improving visual acuity in patients with keratoconus without adversely affecting corneal keratometry after crosslinking.

Indexed as

CollagenCross-Linking ReagentsKeratoconusLens Implantation, IntraocularPhakic Intraocular LensesPhotochemotherapyRefraction, OcularVisual AcuityCorneal Cross-LinkingHumansPhotosensitizing AgentsTreatment OutcomeCollagenCross-Linking ReagentsPhotosensitizing AgentsCorneal cross-linkingICLImplantable Collamer lensKeratoconus

Identifiers

PMID40455349

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.