Clinical Comparative Study Of Implantation Of Scleral-fixated Single-piece Foldable Acrylic And Polymethylmethacrylate(PMMA)Intraocular Lenses In Eyes

Objectives:A prospective clinical study was held to comparatively evaluate the characteristics of implantation of scleral-fixated of single-piece foldable acrylic and polymethylmethacrylate(PMMA) intraocular lenses, for selecting surgical procedures for doctors to provide theoretical basis.Methods:This particular study was a prospective cohort. Non-posterior capsular or disintegrated-posterior capsular eyes were included in this study. Patients were randomly chosen to single-piece foldable acrylic IOL group or polymethylmethacrylate(PMMA) IOL group by one surgeon. Visual acuity(VA), intraocular pressure(IOP), refractive status of cornea, surgical time, postoperative anterior segment inflammation reaction, tear film stability, patients’comfort and related complications.Results:1. Visual acuity(VA):VA increased significantly (P<0.01) in both group between pre-operation and post operation. Foldable acrylic IOL group’s VA was better than PMMA IOL group’s at post operation (P<0.05)2. Intraocular pressure(IOP):There were2cases in foldable acrylic IOL group and1case in PMMA IOL group with IOP<9mmHg separately on the postoperative3days,2cases in foldable acrylic IOL group with IOP>21mmHg and2cases in PMMA IOL group. All hypertension were treated by medicine. Eventually there were one case in foldable acrylic IOL group with IOP>20mmHg, there were no significant difference between preoperative and postoperative (P>0.05). 3. Refractive status of cornea:The SimuIafed Kerotoscope Reading (Sim K) between pre-operation and1week,1month,3months after surgery did not significantly change(P>0.05) in foldable acrylic IOL group, eventually while no significant intergroup difference except the7th day and1month postoperatively (P<0.05) in two groups; The astigmatic power (ΔSim K) significantly changed(P<0.05) between pre-operation and1week after surgery, and did not significantly change (P>0.05) at1month and3months after surgery in foldable acrylic IOL, there were significant difference in PMMA IOL group (P<0.05) at each times and in the two groups; Astigmatic axis of large number of patient were ATR in two groups.4. Operation time:There were significant difference for operation time between foldable acrylic IOL group and PMMA group (P<0.05).5. Tear film stability:There were significant intergroup differences (P<0.05) for CFS, BUT and SIT after surgery.6. Anterior segment inflammation reaction:Postoperative inflammation reactions (including conjunctival congestion, aqueous flare, inflammation cells and corneal edema) were more severe in PMMA group than which in foldable acrylic IOL group.7. Patients’ comfort:Patients had sensations of foreign body, dryness of eye and dacryorrhea, which were more severe in PMMA group than in foldable acrylic IOL group.8. Postoperative complications:Postoperative complications in both groups included temporary hypotension and hypertension were observed. Secondary glaucoma and papillary capture were observed in1case and2cases in foldable acrylic IOL group, Cystoids macular edema were observed in1case in foldable acrylic IOL group. There was respectively1case papillary capture and hyphema in PMMA group. No endophthalmitis and retinal detachment were observed in both groups. There was no Suture erosion happen in two groups.Conclusion:patients visual can be effective improved by whether single-piece foldable acrylic IOL or PMMA IOL in scleral-fixated IOL. Foldable acrylic IOL is higher than PMMA IOL in Visual acuity (VA). Foldable acrylic IOL group has characteristics of smaller incision, quicker healing, lighter inflammation reaction, less complications and more comfort. The long-term postoperative complications are still needed to observe.