title: Intraocular lens dislocation in pseudoexfoliation: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the impact of pseudoexfoliation syndrome on intraocular lens (IOL) dislocation after phacoemulsification cataract surgery and explore possible associations related to surgical technique.
  
  
  METHODS
  We systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and Lilacs databases and grey literature sources and identified (on March 1, 2016) 14 cohort and case-control studies comparing IOL dislocation in patients with and without pseudoexfoliation syndrome who had undergone phacoemulsification. Study quality was assessed using the STROBE scale. An inverse-variance fixed-effects model was used to calculate weighted odds ratios (ORs) and 95% confidence intervals (CI).
  
  
  RESULTS
  The pooled analysis yielded an OR of 6.02 (95% CI: 3.7, 9.79) for IOL dislocation in patients with pseudoexfoliation, and similarly, high ORs were detected for both early and late (3 months after surgery) dislocation (OR 5.26; 95% CI: 1.05; 26.32 versus OR 6.02; 95% CI: 3.67; 10.17). No significant associations were detected when the results were stratified by year, incision size or use of hooks or retractors.
  
  
  CONCLUSIONS
  Patients with pseudoexfoliation syndrome have a high risk of late IOL dislocation after phacoemulsification cataract surgery, and this risk may be related to the use of large incisions and hooks or retractors.
authors: Ophthalmologic Department, Hospital Virxen da Xunqueira, Cee, A Coruña, Spain.|Pharmacy Program, University of Granada, Granada, Spain.
authors: Pedro
authors: P
authors: Vazquez-Ferreiro
authors: Pharmacy Service, Hospital Dr Moliner, Valencia, Spain.
authors: Francisco J
authors: FJ
authors: Carrera-Hueso
authors: Academic Center in Pharmaceutical Care, University of Granada, Granada, Spain.
authors: Narjis
authors: N
authors: Fikri-Benbrahim
authors: Ophthalmologic Department, Hospital Virxen da Xunqueira, Cee, A Coruña, Spain.
authors: Lidia
authors: L
authors: Barreiro-Rodriguez
authors: Ophthalmologic Department, Hospital Virxen da Xunqueira, Cee, A Coruña, Spain.
authors: Marta
authors: M
authors: Diaz-Rey
authors: Hospital Dr Peset, Valencia, Spain.
authors: María Auxiliadora
authors: MA
authors: Ramón Barrios
mesh_terms: D002387:Cataract Extraction / Q000009:adverse effects*; D017889:Exfoliation Syndrome / Q000150:complications*; D005548:Foreign-Body Migration / Q000209:etiology*; D006801:Humans; D007910:Lenses, Intraocular / Q000009:adverse effects*; D011183:Postoperative Complications; D011475:Prosthesis Failure
keywords: exfoliation syndrome; intraoperative complications; lens subluxation; meta-analysis; phacoemulsification