Ursell Paul G, Dhariwal Mukesh, Majirska Katarina, Ender Frank, Kalson-Ray Shoshannah, Venerus Alessandra, Miglio Cristiana, Bouchet Christine
Epsom & St Helier University Hospitals NHS Trust, Epsom, Surrey, UK.
Novartis Ireland Ltd, Dublin, Ireland.
Eye (Lond). 2018 Oct;32(10):1579-1589. doi: 10.1038/s41433-018-0131-2. Epub 2018 Jun 11.
To evaluate 3-year incidence of Nd:YAG capsulotomy and PCO and compare the effect of different IOL materials.
Data were retrospectively collected from seven UK ophthalmology clinics using Medisoft electronic medical records. Eyes from patients ≥65 years undergoing cataract surgery with implantation of acrylic monofocal IOLs during 2010-2013 and 3-year follow-up were analysed. Nd:YAG capsulotomy and PCO incidence proportions were reported for 3 IOL cohorts: AcrySof, other hydrophobic and hydrophilic acrylic IOLs. Unadjusted/adjusted odds ratios (OR) of Nd:YAG capsulotomy were calculated through logistic regression for non-AcrySof cohorts versus AcrySof. A sub-group analysis in single-piece IOLs (>90% of sample eyes) was also performed.
The AcrySof cohort included 13,329 eyes, non-AcrySof hydrophobic 19,025 and non-AcrySof hydrophilic 19,808. The 3-year Nd:YAG capsulotomy incidence (95% CI) for AcrySof (2.4%, 2.2-2.7%) was approximately two times lower than non-AcrySof hydrophobic IOLs (4.4%, 4.1-4.7%) and approximately fourfold lower than non-AcrySof hydrophilic IOLs (10.9%, 10.5-11.3%). Trends were similar in PCO incidence (AcrySof: 4.7%; non-AcrySof hydrophobic: 6.3%; non-AcrySof hydrophilic: 14.8%). Also in the analysis restricted to single-piece IOLs, the pattern remained (2.4% vs 5.1% vs. 10.9%, respectively). Adjusted regression analysis showed a approximately two and fivefold increased odds of Nd:YAG for non-AcrySof hydrophobic and hydrophilic acrylic IOLs respectively vs. AcrySof IOLs. Nd:YAG capsulotomy ORs were similar and remained statistically significant in the single-piece IOL sub-group.
Real-world evidence shows that within 3 years following implantation, AcrySof IOLs are significantly superior in reducing Nd:YAG capsulotomy and PCO incidence compared to other hydrophilic and hydrophobic acrylic IOLs.
评估钕:钇铝石榴石晶状体切开术和后发性白内障的3年发病率，并比较不同人工晶状体材料的效果。
使用Medisoft电子病历从英国七家眼科诊所回顾性收集数据。对2010年至2013年期间接受白内障手术并植入丙烯酸单焦点人工晶状体且随访3年的65岁及以上患者的眼睛进行分析。报告了3个人工晶状体队列的钕:钇铝石榴石晶状体切开术和后发性白内障发病率：AcrySof、其他疏水和亲水丙烯酸人工晶状体。通过逻辑回归计算非AcrySof队列与AcrySof队列钕:钇铝石榴石晶状体切开术的未调整/调整比值比（OR）。还对单片人工晶状体（样本眼的>90%）进行了亚组分析。
AcrySof队列包括13329只眼，非AcrySof疏水型19025只眼，非AcrySof亲水型19808只眼。AcrySof的3年钕:钇铝石榴石晶状体切开术发病率（95%CI）（2.4%，2.2 - 2.7%）比非AcrySof疏水型人工晶状体（4.4%，4.1 - 4.7%）低约两倍，比非AcrySof亲水型人工晶状体（10.9%，10.5 - 11.3%）低约四倍。后发性白内障发病率趋势相似（AcrySof：4.7%；非AcrySof疏水型：6.3%；非AcrySof亲水型：14.8%）。在仅限于单片人工晶状体的分析中，这种模式仍然存在（分别为2.4%对5.1%对10.9%）。调整后的回归分析显示，与AcrySof人工晶状体相比，非AcrySof疏水型和亲水型丙烯酸人工晶状体的钕:钇铝石榴石晶状体切开术发生几率分别增加约两倍和五倍。在单片人工晶状体亚组中，钕:钇铝石榴石晶状体切开术的OR相似且仍具有统计学意义。
真实世界证据表明，在植入后的3年内，与其他亲水型和疏水型丙烯酸人工晶状体相比，AcrySof人工晶状体在降低钕:钇铝石榴石晶状体切开术和后发性白内障发病率方面具有显著优势。
