From the Eye Clinic, Department of Medical, Surgical Sciences and Health, University of Trieste, Trieste, Italy.
J Cataract Refract Surg. 2024 Jun 1;50(6):605-610. doi: 10.1097/j.jcrs.0000000000001421.
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.
Eye Clinic of the University of Trieste, Trieste, Italy.
Retrospective observational study.
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.
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).
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.
评估后房型虹膜夹型人工晶状体（ICIOL）和带翼巩膜内人工晶状体（FIIOL）植入的 Yamane 技术在获得最佳术后效果和屈光结果方面，哪种二次人工晶状体（IOL）植入技术更成功。
意大利的的里雅斯特大学眼科诊所。
回顾性观察性研究。
分析了 110 例 116 只眼的 ICIOL 或 FIIOL 植入术。排除随访时间少于 6 个月或临床资料不完整的患者。收集的数据包括人口统计学、眼部合并症、手术指征、眼压、早期（≤1 个月）和晚期（>1 个月）术后并发症、矫正远视力（CDVA）和最后一次随访时的显微微距视力。
50%（n=58）的眼行 FIIOL 植入术，50%（n=58）行 ICIOL 植入术，用于无晶状体眼（n=44，38%）和 IOL 脱位（n=72，62%）。两组在人口统计学、合并症、随访时间、术后并发症和手术指征方面无统计学差异。FIIOL 组的屈光预测误差（RPE）为 0.69±0.94 屈光度（D），ICIOL 组为 0.21±0.75 D（P=0.03），表明两种技术均存在残留远视。FIIOL 组的 RPE、平均绝对误差和中位数绝对误差更高（P=0.003）。ICIOL 植入术在获得-0.50 D 至+0.50 D 范围内的 RPE 方面更成功（52%的 ICIOL，n=30，31%的 FIIOL，n=18）。
两种技术均能有效提高术前 CDVA，且无统计学差异。尽管并发症发生率无显著差异，但 FIIOL 组的屈光结果更不可预测。不建议调整三部分 IOL 的屈光力，以防止近视漂移，如在睫状沟植入术中所做的那样。
