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眼内晶状体植入术后后囊膜混浊导致激光囊膜切开术发生率的学术虹膜注册研究分析

Academy IRIS Registry Analysis of Incidence of Laser Capsulotomy Due to Posterior Capsule Opacification After Intraocular Lens Implantation.

作者信息

Horn Jeffrey D, Fisher Bret L, Terveen Daniel, Fevrier Helene, Merchea Mohinder, Gu Xiaolin

机构信息

Vision for Life, Nashville, TN, USA.

Eye Center of North Florida, Panama City, FL, USA.

出版信息

Clin Ophthalmol. 2022 Jun 1;16:1721-1730. doi: 10.2147/OPTH.S358059. eCollection 2022.

Abstract

PURPOSE

Academy IRIS (Intelligent Research in Sight) Registry was used to determine the incidence of postoperative neodymium-doped yttrium aluminum garnet laser capsulotomy (Nd:YAG) and time to posterior capsular opacification (PCO) diagnosis based on intraocular lens (IOL) type and brand.

METHODS

This retrospective analysis included eyes implanted with 1 of 2 IOL brands, with ≥365 days of follow-up available in the IRIS Registry, and ≥2 visits within 180 days of surgery. Analyses included Nd:YAG incidence due to PCO within 1 year after surgery by IOL type and brand, mean time to PCO diagnosis, and mean time to Nd:YAG.

RESULTS

Of 89,947 eyes after cataract surgery, 24,834 (28%) had PCO diagnosis within 365 days, and 9262 (10%) underwent Nd:YAG; 4.1% of 57,523 eyes with monofocal and 21.2% of 32,424 eyes with diffractive multifocal (MF) or diffractive extended depth of focus (EDOF) IOLs had Nd:YAG. Nd:YAG was 3.2 times more likely in eyes with diffractive MF or diffractive EDOF IOLs versus monofocal. For monofocal IOLs, 3.2% of eyes with AcrySof and 8.1% of eyes with Tecnis had Nd:YAG (<0.0001). For diffractive MF or diffractive EDOF IOLs, 13.0% of eyes with AcrySof and 21.7% of eyes with Tecnis had Nd:YAG (<0.0001). Nd:YAG risk was 2.4 times higher in eyes with Tecnis versus AcrySof IOLs. Overall, mean time to PCO diagnosis and Nd:YAG was 150.7 and 180.7 days. Mean time to PCO for monofocal versus diffractive MF or diffractive EDOF IOLs was 165.3 versus 139.7 days (<0.0001). Mean time to Nd:YAG for monofocal versus diffractive MF or diffractive EDOF IOLs was 196.4 versus 175.3 days (<0.05).

CONCLUSION

Real-world data for AcrySof and Tecnis IOLs revealed lower Nd:YAG rates and longer time to PCO diagnosis and Nd:YAG after monofocal versus diffractive multifocal or diffractive EDOF implantation. Nd:YAG rates were significantly lower with AcrySof versus Tecnis IOLs.

摘要

目的

利用美国眼科学会智能研究(Academy IRIS)注册库确定基于人工晶状体(IOL)类型和品牌的钕掺杂钇铝石榴石激光晶状体后囊切开术(Nd:YAG)术后发生率以及后囊膜混浊(PCO)诊断时间。

方法

这项回顾性分析纳入了植入两种IOL品牌之一的眼睛,在IRIS注册库中有≥365天的随访数据,且在手术后180天内有≥2次就诊。分析内容包括按IOL类型和品牌划分的术后1年内因PCO导致的Nd:YAG发生率、PCO诊断的平均时间以及Nd:YAG的平均时间。

结果

在89947例白内障手术后的眼睛中,24834例(28%)在365天内被诊断为PCO,9262例(10%)接受了Nd:YAG治疗;在57523例单焦点IOL眼中,4.1%发生了Nd:YAG,在32424例衍射型多焦点(MF)或衍射型扩展景深(EDOF)IOL眼中,21.2%发生了Nd:YAG。与单焦点IOL眼相比,衍射型MF或衍射型EDOF IOL眼发生Nd:YAG的可能性高3.2倍。对于单焦点IOL,AcrySof品牌的眼中3.2%发生了Nd:YAG,Tecnis品牌的眼中8.1%发生了Nd:YAG(<0.0001)。对于衍射型MF或衍射型EDOF IOL,AcrySof品牌的眼中13.0%发生了Nd:YAG,Tecnis品牌的眼中21.7%发生了Nd:YAG(<0.0001)。与AcrySof IOL眼相比,Tecnis IOL眼的Nd:YAG风险高2.4倍。总体而言,PCO诊断和Nd:YAG的平均时间分别为150.7天和180.7天。单焦点IOL与衍射型MF或衍射型EDOF IOL的PCO平均诊断时间分别为165.3天和139.7天(<0.0001)。单焦点IOL与衍射型MF或衍射型EDOF IOL的Nd:YAG平均时间分别为196.4天和175.3天(<0.05)。

结论

AcrySof和Tecnis IOL的真实世界数据显示,与衍射型多焦点或衍射型EDOF植入相比,单焦点植入后的Nd:YAG发生率更低,PCO诊断和Nd:YAG的时间更长。与Tecnis IOL相比,AcrySof IOL的Nd:YAG发生率显著更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a618/9167596/3c5e70fe5ea6/OPTH-16-1721-g0001.jpg

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