Long-term functional outcome between Yamane technique and retropupillary iris-claw technique in a large study cohort.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY Journal of cataract and refractive surgery Pub Date : 2024-06-01 DOI:10.1097/j.jcrs.0000000000001421

Pier Luigi Guerin, Gian Marco Guerin, Marco Rocco Pastore, Stefano Gouigoux, Daniele Tognetto

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Abstract

Purpose: To evaluate which secondary intraocular lens (IOL) implantation technique was more successful in achieving the best postoperative results and refractive outcomes between retropupillary iris-claw IOL (ICIOL) and flanged intrascleral IOL (FIIOL) fixation with the Yamane technique.

Setting: Eye Clinic of the University of Trieste, Trieste, Italy.

Design: Retrospective observational study.

Methods: 116 eyes of 110 patients who underwent ICIOL or FIIOL were analyzed. Patients with follow-up shorter than 6 months or with incomplete clinical data were excluded. Collected data included demographics, ocular comorbidity, indication of surgery, intraocular pressure, early (≤1 month) and late (>1 month) postoperative complications, corrected distance visual acuity (CDVA), and manifest refraction at the last follow-up visit.

Results: 50% (n = 58) of eyes underwent FIIOL and 50% (n = 58) ICIOL implantation for aphakia (n = 44, 38%) and IOL dislocation (n = 72, 62%). No statistically significant differences in demographics, comorbidity, follow-up duration, postoperative complications, and surgical indications were found. The refractive prediction error (RPE) was 0.69 ± 0.94 diopter (D) in the FIIOL group and 0.21 ± 0.75 D in the ICIOL group ( P = .03), indicating residual hyperopia after both techniques. RPE, mean absolute error, and median absolute error were higher in the FIIOL group ( P = .003). ICIOL implantation was more successful in obtaining a RPE between -0.50 D and +0.50 D (52% of ICIOL, n = 30, and 31% of FIIOL, n = 18).

Conclusions: Both techniques were effective in increasing preoperative CDVA with no statistical difference between them. Although complication rates did not significantly differ, the FIIOL group exhibited less predictable refractive outcomes. Adjusting the dioptric power of the 3-piece IOL, as performed in ciliary sulcus implantation, to prevent myopic shift, is not recommended.

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在一项大型研究队列中，山根技术和后瞳孔虹膜-爪技术的长期功能结果。

目的：评估瞳孔后虹膜爪式人工晶体植入术（ICIOL）和用Yamane技术进行的带法兰巩膜内人工晶体固定术（FIIOL）之间，哪种二次人工晶体植入技术能更成功地获得最佳术后效果和屈光结果：方法：对接受 ICIOL 或 FIIOL 手术的 110 名患者的 116 只眼睛进行分析。随访时间不足 6 个月或临床数据不完整的患者被排除在外。收集的数据包括人口统计学、眼部合并症、手术指征、眼压（IOP）、术后早期（≤1个月）和晚期（>1个月）并发症、BCVA和最后一次随访时的屈光度：50%（n=58）的眼球因无晶体眼（n=44，38%）和人工晶体脱位（n=72，62%）接受了FIIOL植入术，50%（n=58）接受了ICIOL植入术。在人口统计学、合并症、随访时间、术后并发症和手术适应症方面没有发现明显差异。FIIOL组的屈光预测误差（RPE）为0.69±0.94D，ICIOL组为0.21±0.75D（P=0.03），表明两种技术术后均有远视残留。FIIOL组的RPE、平均绝对误差（MAE）和中位数绝对误差（MedAE）更高（P = 0.003）。ICIOL植入术在获得-0.50D到+0.50D之间的RPE方面更为成功（ICIOL为52%，n=30；FIIOL为31%，n=18）。结论：两种技术都能有效提高术前BCVA，两者之间没有统计学差异。虽然并发症发生率没有明显差异，但 FIIOL 组的屈光结果较难预测。不建议像睫状沟植入术那样调整三片式人工晶体的屈光度以防止近视偏移。

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来源期刊

$Journal of cataract and refractive surgery$

Journal of cataract and refractive surgery 医学-外科

CiteScore

5.60

自引率

14.30%

发文量

259

审稿时长

8.5 weeks

期刊介绍： The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.