To systematically evaluate the efficacy of phacoemulsification and intraocular lens (IOL) with and without capsular tension ring (CTR) in patients with high myopia and cataract.

MEDLINE, EMBASE, Cochrane Library, and Chinese databases including CNKI, Wanfang Data, and VIP databases were searched from their establishment to October 2020 to obtain peer-reviewed clinical studies comparing the efficacy of cataract phacoemulsification and IOL implantation combined with CTR implantation (experimental group) and cataract phacoemulsification and IOL implantation (control group) in patients with high myopia and cataract.Literature screening, data extraction and methodological quality assessment were implemented based on inclusion and exclusion criteria.A meta-analysis of postoperative best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution unit, posterior capsular opacification (PCO), capsular contraction syndrome (CCS), retinal detachment (RD) was performed using Revman 5.3 software with mean difference (MD) and odds ratio (OR) describing the effect sizes of measurement data and count data, respectively.

Eight studies with 2 085 eyes were included in this study, including 1 054 eyes in the experimental group and 1 031 eyes in the control group.Meta-analysis showed that there was no significant difference in BCVA between the two groups at 1 week, 1 month, and 3 months after surgery, but the improvement in BCVA at 6 months after surgery was significantly better in the experimental group than in the control group (MD: -0.11; 95% CI: -0.15--0.07; P<0.01). The incidence rates of postoperative PCO (OR: 0.24; 95% CI: 0.15-0.36; P<0.01) and CCS (OR: 0.08; 95 % CI: 0.01-0.65; P=0.02) and RD (OR: 0.21; 95% CI: 0.05-0.82; P=0.02) were lower in the experimental group than in the control group, and the differences were statistically significant.

The combination of CTR in the treatment of patients with high myopia and cataract can improve the postoperative visual quality and reduce the incidence of postoperative PCO, CCS and RD.

Cataract; High myopia; Capsular tension ring; Meta-analysis