Stefano Ranno1, Giovanni Mario Rabbiolo2, Stefano Lucentini2, Edoardo Ruggiero2, Saverio Vincenzo Luccarelli2, Linda Lombardi3, Paolo Nucci2,4. 1. University Eye Clinic, San Giuseppe Hospital, IRCCS MultiMedica, Via San Vittore 12, 20123, Milan, MI, Italy. stefano.ranno@gmail.com. 2. University Eye Clinic, San Giuseppe Hospital, IRCCS MultiMedica, Via San Vittore 12, 20123, Milan, MI, Italy. 3. Plannin & Control Department, San Giuseppe Hospital, IRCCS MultiMedica, Milan, Italy. 4. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Abstract
PURPOSE: To compare visual, anatomical and economical outcomes of patients with secondary anterior chamber intraocular lens (AC-IOL) implantation and secondary scleral fixated intraocular lens (SF-IOL) implantation. METHODS: In this retrospective observational study, 38 aphakic patients after complicated phacoemulsification divided in two groups, AC-IOL group (17 patients receiving AC-IOL implantation) and SF-IOL group (21 patients receiving SF-IOL implantation). Corrected distance visual acuity (CDVA), patient reported visual outcome (VF-14) and endothelial cell density (ECD) were measured at baseline and two-year follow-up. Complication rate was registered. The global cost of each procedure and the incremental cost-effectiveness ratio (ICER) were calculated. RESULTS: No statistically significant difference was found in CDVA (logMAR 0.24 ± 0.17 vs. 0.32 ± 0.26, p = 0.27), VF-14 (68 ± 18 vs. 61 ± 20, p = 0.24), ECD (1456.48 ± 525.15 vs. 1341.71 ± 374.33, p = 0.48) and overall complication rate (p = 0.79) postoperatively between the SF-IOL group and the AC-IOL group. The ECD loss rate was significantly higher in the AC-IOL group (15.5% vs. 3.5%, p = 0.004). The average global cost of the two procedures was higher in the SF-IOL group (p < 0.005) and ICER showed an additional payment of 693 € for each patient in SF-IOL group against a saving of 186 endothelial cells 2 years postoperatively. CONCLUSION: AC IOL and SF-IOL implantation showed similar outcomes in terms of visual function and safety profile. Higher ECD loss was found in AC-IOL group. The global cost of implantation was significantly lower for AC-IOL, but the ICER seems to justify the SF-IOL implantation in patients with low ECD.
PURPOSE: To compare visual, anatomical and economical outcomes of patients with secondary anterior chamber intraocular lens (AC-IOL) implantation and secondary scleral fixated intraocular lens (SF-IOL) implantation. METHODS: In this retrospective observational study, 38 aphakic patients after complicated phacoemulsification divided in two groups, AC-IOL group (17 patients receiving AC-IOL implantation) and SF-IOL group (21 patients receiving SF-IOL implantation). Corrected distance visual acuity (CDVA), patient reported visual outcome (VF-14) and endothelial cell density (ECD) were measured at baseline and two-year follow-up. Complication rate was registered. The global cost of each procedure and the incremental cost-effectiveness ratio (ICER) were calculated. RESULTS: No statistically significant difference was found in CDVA (logMAR 0.24 ± 0.17 vs. 0.32 ± 0.26, p = 0.27), VF-14 (68 ± 18 vs. 61 ± 20, p = 0.24), ECD (1456.48 ± 525.15 vs. 1341.71 ± 374.33, p = 0.48) and overall complication rate (p = 0.79) postoperatively between the SF-IOL group and the AC-IOL group. The ECD loss rate was significantly higher in the AC-IOL group (15.5% vs. 3.5%, p = 0.004). The average global cost of the two procedures was higher in the SF-IOL group (p < 0.005) and ICER showed an additional payment of 693 € for each patient in SF-IOL group against a saving of 186 endothelial cells 2 years postoperatively. CONCLUSION: AC IOL and SF-IOL implantation showed similar outcomes in terms of visual function and safety profile. Higher ECD loss was found in AC-IOL group. The global cost of implantation was significantly lower for AC-IOL, but the ICER seems to justify the SF-IOL implantation in patients with low ECD.