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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 I\u00b2 and incision-type subgroups was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five studies comprising 631 eyes (229 Carlevale, 402 iris-claw) met inclusion criteria. Mean age was 70.1\u2009\u00b1\u200914.1 years, 61.18% were male; follow-up ranged from 1.3 to 11.5 months. BCVA did not differ between groups (\u2212\u20090.01 logMAR; 95% CI\u2009\u2212\u20090.13\u2009\u2212\u20090.11;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.91; I\u00b2=43%). Carlevale reduced SIA (\u2212\u20090.53D; 95% CI\u2009\u2212\u20091.03 to \u2212\u20090.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03; I\u00b2=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,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.30, I\u00b2 =81.7%). Carlevale produced a myopic shift relative to iris-claw (\u2212\u20090.66D; 95% CI\u2009\u2212\u20090.87 to \u2212\u20090.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01; I\u00b2=31.3%). Carlevale procedures were 11.9\u00a0min longer (95% CI 5.2\u201318.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01; I\u00b2=80.2%). Complication rates were comparable overall except for fewer IOL dislocations with Carlevale (OR 0.16; 95% CI 0.03\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034; I\u00b2=0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-026-07263-8","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:02:58Z","timestamp":1778050978000},"page":"2693-2702","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Carlevale and Artisan retropupillary iris-claw intraocular lens fixation for managing aphakia: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"264","author":[{"given":"Omar","family":"Alghaith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3702-0827","authenticated-orcid":false,"given":"Tiago Nelson","family":"de Oliveira Rassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negin","family":"Sanadgol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehtesham","family":"Shamsher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Barreiros","family":"Pungirum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Bao","family":"Nghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Khabazianzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maur\u00edcio","family":"Maia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"issue":"3","key":"7263_CR1","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/aos.14307","volume":"98","author":"MP Czajka","year":"2020","unstructured":"Czajka MP, Frajdenberg A, Stopa M, Pabin T, Johansson B, Jakobsson G (2020) Sutureless intrascleral fixation using different three-piece posterior chamber intraocular lenses: a literature review of surgical techniques in cases of insufficient capsular support and a retrospective multicentre study. 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