Table 4.
Logistic regression for factors associated with currently performing immediate sequential bilateral ICL surgery (ISBICLS)
| P-value | Adjusted odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | ||
|---|---|---|---|---|---|---|---|
| Job title | |||||||
| Attending physician | Reference | Reference | |||||
| Associated chief physician | 0.318 | 0.706 (0.356,1.399) | 0.144 | 0.588 (0.289,1.199) | 0.17 | 0.604 (0.294,1.241) | |
| Chief physician | 0.304 | 0.691 (0.341,1.399) | 0.074 | 0.501 (0.235,1.068) | 0.081 | 0.505 (0.234,1.089) | |
| Departments | |||||||
| Optometry department (refractive surgery department) | Reference | Reference | Reference | ||||
| Cataract or lens surgery department | 0.032 | 0.637 (0.422,0.963) | 0.057 | 0.636 (0.400,1.014) | 0.051 | 0.627 (0.393,1.002) | |
| Others | 0.781 | 0.896 (0.411,1.95) | 0.899 | 1.055 (0.459,2.425) | 0.993 | 0.996 (0.429,2.313) | |
| Type of medical institution | |||||||
| Public general hospital | Reference | Reference | Reference | ||||
| Public specialized hospital | 0.795 | 0.909 (0.443, 1.866) | 0.1 | 1.565 (0.917, 2.670) | 0.925 | 1.038 (0.478, 2.255) | |
| Private general hospital | 0.11 | 2.277 (0.829, 6.253) | 0.983 | 0.992 (0.462, 2.129) | 0.172 | 2.14 (0.719, 6.373) | |
| Private specialized hospital | 0.033 | 1.724 (1.045, 2.843) | 0.088 | 2.501 (0.873, 7.166) | 0.203 | 1.432 (0.824, 2.488) | |
| Level of medical institution | |||||||
| Provincial level | Reference | Reference | Reference | ||||
| Municipal level | 0.245 | 1.629 (0.716, 3.708) | 0.274 | 1.611 (0.686, 3.781) | 0.35 | 1.515 (0.633, 3.625) | |
| Others | 0.994 | 1.002 (0.616, 1.63) | 0.906 | 1.031 (0.617, 1.724) | 0.826 | 1.061 (0.629, 1.788) | |
| When did you start performing ICL surgery | |||||||
| Before 2010 | 0.009 | 2.772 (1.290, 5.957) | 0.02 | 2.505 (1.152, 5.447) | |||
| 2011–2013 | 0.036 | 2.479 (1.060, 5.800) | 0.043 | 2.433 (1.029, 5.755) | |||
| 2014–2016 | 0.32 | 1.426 (0.709, 2.868) | 0.397 | 1.356 (0.67, 2.744) | |||
| 2017–2019 | 0.279 | 1.378 (0.771, 2.464) | 0.376 | 1.305 (0.724, 2.354) | |||
| After 2020 | reference | ||||||
| How many ICL surgeries have you performed in the past year | |||||||
| < 100 | Reference | Reference | |||||
| 100–500 | 0.649 | 1.152 (0.627, 2.115) | 0.526 | 1.223 (0.657, 2.274) | |||
| 501–1000 | 0.657 | 1.253 (0.462, 3.398) | 0.628 | 1.285 (0.466, 3.546) | |||
| > 1000 | 0.719 | 0.782 (0.204, 2.995) | 0.799 | 0.837 (0.213, 3.286) | |||
| Until now, how many ICL surgeries have you performed? | |||||||
| < 200 | Reference | Reference | |||||
| 200–1000 | 0.111 | 0.589 (0.307, 1.129) | 0.154 | 0.627 (0.33, 1.192) | |||
| 1001–3000 | 0.462 | 0.705 (0.278, 1.789) | 0.701 | 0.835 (0.332, 2.101) | |||
| > 3000 | 0.438 | 0.594 (0.159, 2.217) | 0.618 | 0.72 (0.198, 2.619) | |||
| How long did it take for you to complete an ICL surgery for one eye? | |||||||
| ≤ 3 min | 0.005 | 3.936 (1.505, 10.293) | 0.008 | 3.751 (1.41, 9.978) | |||
| 4–6 min | 0.119 | 1.976 (0.840, 4.645) | 0.112 | 2.032 (0.848, 4.867) | |||
| 7–10 min | 0.092 | 2.167 (0.881, 5.330) | 0.111 | 2.114 (0.841, 5.311) | |||
| > 10 min | |||||||
| ICL surgery management type | |||||||
| Outpatient or day care surgery | Reference | Reference | |||||
| Inpatient surgery | 0.059 | 0.593 (0.345, 1.019) | 0.105 | 0.633 (0.364, 1.1) | |||
| Preoperative measurement devices when designing ICL size(others-reference) | |||||||
| Pentacam measurements (ACD, WTW) | 0.084 | 1.540 (0.944, 2.512) | 0.06 | 1.617 (0.98, 2.666) | |||
| UBM measurements (STS) | 0.106 | 1.427 (0.928, 2.194) | 0.062 | 1.52 (0.979, 2.361) | |||
| What percentage of time do you modify your ICL selection in the second eye according to the vault from the first eye? | |||||||
| 0% (I never referred to the first eye) | Reference | ||||||
| 1–25% | 0.01 | 0.183 (0.05, 0.669) | |||||
| 26–50% | 0.013 | 0.173 (0.043, 0.695) | |||||
| 51–75% | 0.091 | 0.276 (0.062, 1.23) | |||||
| 76–100% | 0.009 | 0.157 (0.039, 0.631) | |||||
Multivariable regression models were performed to evaluate factors associated with surgeons currently performing ISBICLS. The variables in the univariate logistic regression model (eTable 2) with P-value < 0.05 were included as covariables in the multivariate logistic models. For the association of clinical settings with the outcome, we adjusted for demographic characteristics (job title, departments, medical institution type, and medical institution level). For the association of surgeon experience or skills with ICL surgery, we adjusted additionally when to start ICL surgery, the total surgical volume, the time of one-eye ICL surgery, the preoperative measurement devices, and ICL surgery management type, except for the percentage of modifying the second eye ICL selection (due to potential mediation). Finally, we made a fully adjusted logistic regression model