CLINICAL OUTCOMES OF ANTERIOR CHAMBER VS. SCLERAL FIXATED INTRAOCULAR LENSES IN COMPLICATED CATARACT SURGERIES PERFORMED BY OPHTHALMOLOGY RESIDENTS

摘要

?Purpose?Cataract surgeries can be complicated by a variety of mechanisms, which require an alternative approach to completing the operation. The purpose of this study is to compare the outcome of anterior chamber intraocular lens (ACIOL) vs scleral-fixated intraocular lens (SFIOL) implantation in complicated cataract surgeries. ?Methods?This is a retrospective study of consecutive ACIOL and SFIOL implantation surgeries performed at Los Angeles County USC Hospital from 2012 to 2013. Patients were identified from an operative log documenting complicated cataract surgeries during the study period. Exclusion criteria included: (1) causes of poor visual function other than cataract prior to cataract surgery, (2) combined surgery, such as corneal surgery and glaucoma surgery; and (3) postoperative follow-up of less than 12 months. Patient demographics, surgeon experience, type of surgical complication, follow-up duration, type of IOL implanted, postoperative visual acuity, and postoperative complications were collected from each case record. This study was approved by the Institutional Review Board. ?Results?There were a total of 20 eyes in the ACIOL group and 10 eyes in the SFIOL group. The most common complicating factors were posterior capsule rupture and zonular dehiscence. Average time of ophthalmic surgery training of the resident surgeon was 26 months. The mean follow-up duration was 18 months. Analysis of visual outcome showed ACIOL and SFIOL implantation had similar results, while the presence of late complications was associated with a worse final visual outcome. ?Conclusions?Many factors can contribute to the clinical outcomes of complicated cataract surgeries involving ACIOL and SFIOL implantation. This study shows that clinical results are similar in both groups when performed by ophthalmology residents and that other factors are more important in determining final visual outcomes. ?.