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Comparison of long-term surgical outcomes for scleral-fixated versus retropupillary iris-claw intraocular lens

Authors
 Hyun Goo Kang  ;  Jae Won Jun  ;  Eun Young Choi  ;  Suk Ho Byeon  ;  Sung Soo Kim  ;  Hyoung Jun Koh  ;  Min Kim 
Citation
 CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, Vol.49(7) : 686-695, 2021-09 
Journal Title
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
ISSN
 1442-6404 
Issue Date
2021-09
MeSH
Aged ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Postoperative Complications ; Retrospective Studies ; Sclera / surgery ; Treatment Outcome ; Visual Acuity
Keywords
endothelial cells ; intraocular ; intraoperative complications ; lens implantation ; treatment outcome
Abstract
Background: To compare the clinical features and long-term treatment outcomes of patients undergoing secondary intraocular lens (IOL) surgery with scleral-fixated (SFIOL) versus retropupillary iris-claw IOL (RPICIOL).

Methods: Consecutive patients treated between June 2014 and December 2019 at two tertiary centres were retrospectively reviewed. The primary outcome was the best-corrected visual acuity (BCVA). Secondary outcomes included factors associated with significant corneal endothelial injury and postoperative redislocation.

Results: This study included 395 eyes undergoing surgery with SFIOL (237 eyes, 60%) or RPICIOL (158 eyes, 40%), with no differences in baseline BCVA (p = 0.76) or endothelial cell density (ECD) (p = 0.39). Compared with the SFIOL group, the RPICIOL group had faster visual recovery (postoperative month 1, 20/37 vs. 20/46, p = 0.005) sustained to over 36 months (p = 0.034), favourable absolute prediction errors (within 0.5D, 67.3% vs. 54.9%, p = 0.027), and shorter operation times (52.7 vs. 60.9 min, p = 0.015). There was no difference in ECD after 12 months (P = 0.282). Over a mean follow-up duration of 33 months (152 cases >3 years, 38.5%), the SFIOL group experienced more cases of tilted/decentred IOLs (14 vs. 1, p = 0.006), suture exposure (7 vs. 0, p = 0.045), and redislocation (17.7% vs. 10.1%, p < 0.001). Multivariable regression showed that a final BCVA below 20/40 was associated with SFIOL (P = 0.007), older age (p = 0.001), intraoperative complications (p = 0.002), past history of vitrectomy/glaucoma surgery or uveitis (p = 0.046), and surgically induced astigmatism >1D (p = 0.029).

Conclusions: RPICIOL appears to be a safe and effective surgical option for secondary IOL surgery over a long-term follow-up, comparing favourably against conventional SFIOL.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/ceo.13965
DOI
10.1111/ceo.13965
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hyun Goo(강현구) ORCID logo https://orcid.org/0000-0001-8359-9618
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Kim, Sung Soo(김성수) ORCID logo https://orcid.org/0000-0002-0574-7993
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Choi, Eun Young(최은영) ORCID logo https://orcid.org/0000-0002-1668-6452
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187074
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