SynthesisGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Comparison of Carlevale and Artisan retropupillary iris-claw intraocular lens fixation for managing aphakia: a systematic review and meta-analysis.
Synthesis in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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0 citing papers in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCarlevale and retropupillary iris-claw Artisan intra-ocular lenses (IOLs) treat aphakia without capsular support, but their relative performance is uncertain.
methodsPubMed, Embase and the Cochrane Library were searched to March 2025. PRIMARY OUTCOMES: best-corrected visual acuity (BCVA), surgically induced astigmatism (SIA), mean absolute refractive error (MARE) and mean refractive error (MRE). SECONDARY OUTCOMES: operating time and postoperative complications. Random-effects meta-analysis with I² and incision-type subgroups was performed.
resultsFive studies comprising 631 eyes (229 Carlevale, 402 iris-claw) met inclusion criteria. Mean age was 70.1 ± 14.1 years, 61.18% were male; follow-up ranged from 1.3 to 11.5 months. BCVA did not differ between groups (- 0.01 logMAR; 95% CI - 0.13 - 0.11; p = 0.91; I²=43%). Carlevale reduced SIA (- 0.53D; 95% CI - 1.03 to - 0.04; p = 0.03; I²=73.7%), however, the benefit was confined to corneal-incision iris-claw comparators, not scleral-incision. MARE showed no overall difference, yet corneal-incision iris-claw cases were less predictable (MD-0.32; 95% Cl: -0.62-0.19, p = 0.30, I² =81.7%). Carlevale produced a myopic shift relative to iris-claw (- 0.66D; 95% CI - 0.87 to - 0.46; p < 0.01; I²=31.3%). Carlevale procedures were 11.9 min longer (95% CI 5.2-18.6; p < 0.01; I²=80.2%). Complication rates were comparable overall except for fewer IOL dislocations with Carlevale (OR 0.16; 95% CI 0.03-0.87; p = 0.034; I²=0%).
conclusionsBoth lenses provide similar visual acuity and safety in aphakic eyes lacking capsular support. Carlevale confers lower dislocation risk and greater refractive predictability relative to corneal-incision iris-claw implantation, at the expense of a longer operating time. Incision-related heterogeneity highlights the need for standardised surgical and reporting frameworks.
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