Abstract：
To identify changes in secondary lens techniques over time and to determine common complications of each technique.
Retrospective cohort study.
All patients in the database from January 2015 to December 2021 who underwent secondary lens placement (anterior chamber intraocular lens [IOL, ACIOL], scleral-fixated IOL [SFIOL], or scleral-sutured IOL [SSIOL]).
Rates of secondary IOL surgery techniques were analyzed in 3597 participants in a nationwide aggregated electronic health care database using 2-sample independent t tests. Rates of postoperative rhegmatogenous retinal detachment (RRD) after secondary IOL surgery were assessed using chi-square test of proportion. Postoperative visual acuity (VA) was assessed using 2-sample independent t tests.
The primary outcome was change in IOL technique over time. Secondary data points examined were the development of postoperative RRD after secondary IOL surgery, VA changes, the development of endophthalmitis, suture erosion, haptic erosion, or corneal edema after IOL surgery.
Anterior chamber IOL use decreased over the 7-year period from 93% of cases to 36% of cases (P < 0.0001), while SFIOL use increased from 3% to 34% (P < 0.0001) and SSIOL use increased from 4% to 30% (P < 0.0001). Visual acuity increased for each surgical technique (ACIOL: 44.1 vs. 49.2 ETDRS letters, P < 0.001; SFIOL: 48.7 vs. 57.6 letters, P < 0.001; SSIOL: 51.5 vs. 61.2 letters, P < 0.001), with larger VA gains seen in SFIOL and SSIOL use (ACIOL vs. SFIOL, P = 0.004; ACIOL vs. SSIOL, P = 0.002; SFIOL vs. SSIOL, P = 0.64). Average RRD rates did not significantly differ between techniques. Rates of endophthalmitis, haptic erosion, and suture erosion were low and did not significantly differ between techniques. Rates of corneal edema were significantly higher in ACIOL cases (vs. SFIOL, P < 0.0001; vs. SSIOL, P < 0.0001).
Rates of ACIOL implantation performed by vitreoretinal surgeons have decreased over time with more vitreoretinal surgeons electing to place either an SFIOL or SSIOL toward the end of the study period; complication profiles among the 3 techniques may be similar.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Retrospective cohort study.
All patients in the database from January 2015 to December 2021 who underwent secondary lens placement (anterior chamber intraocular lens [IOL, ACIOL], scleral-fixated IOL [SFIOL], or scleral-sutured IOL [SSIOL]).
Rates of secondary IOL surgery techniques were analyzed in 3597 participants in a nationwide aggregated electronic health care database using 2-sample independent t tests. Rates of postoperative rhegmatogenous retinal detachment (RRD) after secondary IOL surgery were assessed using chi-square test of proportion. Postoperative visual acuity (VA) was assessed using 2-sample independent t tests.
The primary outcome was change in IOL technique over time. Secondary data points examined were the development of postoperative RRD after secondary IOL surgery, VA changes, the development of endophthalmitis, suture erosion, haptic erosion, or corneal edema after IOL surgery.
Anterior chamber IOL use decreased over the 7-year period from 93% of cases to 36% of cases (P < 0.0001), while SFIOL use increased from 3% to 34% (P < 0.0001) and SSIOL use increased from 4% to 30% (P < 0.0001). Visual acuity increased for each surgical technique (ACIOL: 44.1 vs. 49.2 ETDRS letters, P < 0.001; SFIOL: 48.7 vs. 57.6 letters, P < 0.001; SSIOL: 51.5 vs. 61.2 letters, P < 0.001), with larger VA gains seen in SFIOL and SSIOL use (ACIOL vs. SFIOL, P = 0.004; ACIOL vs. SSIOL, P = 0.002; SFIOL vs. SSIOL, P = 0.64). Average RRD rates did not significantly differ between techniques. Rates of endophthalmitis, haptic erosion, and suture erosion were low and did not significantly differ between techniques. Rates of corneal edema were significantly higher in ACIOL cases (vs. SFIOL, P < 0.0001; vs. SSIOL, P < 0.0001).
Rates of ACIOL implantation performed by vitreoretinal surgeons have decreased over time with more vitreoretinal surgeons electing to place either an SFIOL or SSIOL toward the end of the study period; complication profiles among the 3 techniques may be similar.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
摘要：
目的：确定二次晶状体技术随时间的变化，并确定每种技术的常见并发症。
方法：回顾性队列研究。
方法：2015年1月至2021年12月数据库中所有接受二次晶状体放置的患者（前房人工晶状体，巩膜固定IOL,或巩膜缝合IOL)。
方法：使用2个独立样本的T检验，在全国汇总的电子医疗数据库中对3597名参与者进行了二次IOL手术技术的比率分析。二次IOL手术后孔源性视网膜脱离（RRD）的发生率使用比例卡方检验进行评估。使用2个独立的T检验评估术后视力。
方法：主要结果是IOL技术随时间的变化。检查的次要数据点是二次IOL手术后的术后孔源性视网膜脱离（RRD）的发展，视力变化，眼内炎的发展，缝线侵蚀,触觉侵蚀，或IOL手术后角膜水肿。
结果：在7年期间，ACIOL的使用从93％下降到36％（p<0.0001），而SFIOL的使用从3%增加到34%(p<0.0001)，SSIOL使用率从4%增加到30%(p<0.0001)。每种手术技术的视力都会增加（ACIOL：44.1vs.49.2早期治疗糖尿病视网膜病变研究（ETDRS）字母，p<0.001；SFIOL：48.7vs.57.6字母，p<0.001；SSIOL：51.5vs.61.2字母，p<0.001)，在SFIOL和SSIOL使用中观察到更大的视力增益(ACIOL与SFIOL,p=0.004;ACIOLvs.SSIOL,p=0.002;SFIOLvs.SSIOL,p=0.64）。技术之间的平均RRD率没有显着差异。眼内炎的发生率，触觉侵蚀，和缝线侵蚀较低，技术之间没有显着差异。在ACIOL病例中，角膜水肿的发生率显着升高（与SFIOL,p<0.0001;vs.SSIOL,p<0.0001)。
结论：玻璃体视网膜外科医生进行ACIOL植入的比率随着时间的推移而下降，更多的玻璃体视网膜外科医生选择在研究期结束时放置SFIOL或SSIOL；三种技术的并发症情况可能相似。
方法：回顾性队列研究。
方法：2015年1月至2021年12月数据库中所有接受二次晶状体放置的患者（前房人工晶状体，巩膜固定IOL,或巩膜缝合IOL)。
方法：使用2个独立样本的T检验，在全国汇总的电子医疗数据库中对3597名参与者进行了二次IOL手术技术的比率分析。二次IOL手术后孔源性视网膜脱离（RRD）的发生率使用比例卡方检验进行评估。使用2个独立的T检验评估术后视力。
方法：主要结果是IOL技术随时间的变化。检查的次要数据点是二次IOL手术后的术后孔源性视网膜脱离（RRD）的发展，视力变化，眼内炎的发展，缝线侵蚀,触觉侵蚀，或IOL手术后角膜水肿。
结果：在7年期间，ACIOL的使用从93％下降到36％（p<0.0001），而SFIOL的使用从3%增加到34%(p<0.0001)，SSIOL使用率从4%增加到30%(p<0.0001)。每种手术技术的视力都会增加（ACIOL：44.1vs.49.2早期治疗糖尿病视网膜病变研究（ETDRS）字母，p<0.001；SFIOL：48.7vs.57.6字母，p<0.001；SSIOL：51.5vs.61.2字母，p<0.001)，在SFIOL和SSIOL使用中观察到更大的视力增益(ACIOL与SFIOL,p=0.004;ACIOLvs.SSIOL,p=0.002;SFIOLvs.SSIOL,p=0.64）。技术之间的平均RRD率没有显着差异。眼内炎的发生率，触觉侵蚀，和缝线侵蚀较低，技术之间没有显着差异。在ACIOL病例中，角膜水肿的发生率显着升高（与SFIOL,p<0.0001;vs.SSIOL,p<0.0001)。
结论：玻璃体视网膜外科医生进行ACIOL植入的比率随着时间的推移而下降，更多的玻璃体视网膜外科医生选择在研究期结束时放置SFIOL或SSIOL；三种技术的并发症情况可能相似。
