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.

中文翻译：

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白内障术后无晶状体患者的角度支持人工晶状体与巩膜缝合后房型人工晶状体：两年随访成本效益分析。

目的 比较二次前房人工晶状体 (AC-IOL) 植入和二次巩膜固定人工晶状体 (SF-IOL) 植入患者的视觉、解剖和经济结果。方法 在这项回顾性观察研究中，38 例无晶状体患者在复杂超声乳化术后分为两组，AC-IOL 组（17 例接受 AC-IOL 植入）和 SF-IOL 组（21 例接受 SF-IOL 植入）。在基线和两年随访时测量校正远视力 (CDVA)、患者报告的视力结果 (VF-14) 和内皮细胞密度 (ECD)。并发症发生率已登记。计算了每个程序的总体成本和增量成本效益比 (ICER)。结果 在 CDVA 中没有发现统计学上的显着差异（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) 和总体并发症发生率 (p = 0.79 ) SF-IOL 组和 AC-IOL 组术后。AC-IOL 组的 ECD 丢失率显着更高（15.5% 对 3.5%，p = 0.004）。SF-IOL 组两种手术的全球平均成本较高（p < 0.005），ICER 显示 SF-IOL 组每位患者额外支付 693 欧元，而术后 2 年节省了 186 个内皮细胞。结论 AC IOL 和 SF-IOL 植入在视觉功能和安全性方面显示出相似的结果。AC-IOL组ECD损失较高。AC-IOL 的全球植入成本显着降低，但 ICER 似乎证明了在低 ECD 患者中植入 SF-IOL 的合理性。