Outcomes in Patients Having Vitreous Presentation During Cataract Surgery Who Lack Capsular Support for a Nonsutured PC IOL
Accepted 18 August 2005. published online 10 October 2005.
Purpose
The study’s purpose was to determine the effect that lack of capsular support for a nonsutured posterior chamber (PC) intraocular lens IOL has on 1-year postoperative vision in patients suffering vitreous presentation (VP) during extracapsular cataract surgery.
Design
The study was a prospective, long-term clinical trial.
Methods
The study was conducted at 19 Department of Veterans Affairs medical centers. Patients having VP during cataract surgery with sufficient capsular support for a nonsutured PC IOL were randomized to receive either a PC IOL (230 patients) or an anterior chamber (AC) IOL (208 patients). Patients having insufficient capsular support (ICS) for a nonsutured PC IOL (143 patients) were prospectively followed in the same fashion. Best-corrected visual acuity (BCVA) at 1 year was obtained by a masked, certified examiner.
Results
The ICS group had considerably fewer patients with BCVA of 20/40 or better at 1 year (P < .0001) than the randomized PC IOL group (66.7% vs 91.1%) with a trend (P = .04) for having fewer patients than the randomized AC IOL group (66.7% vs 79.0%). The ICS group had significantly poorer rating of vision at 1 year by study raters, and the patients themselves than either of the randomized VP groups.
Conclusions
The lack of capsular support for the placement of a nonsutured PC IOL after VP during extracapsular cataract surgery or the severity of the complication of VP associated with lack of capsular support would appear to cause visual problems beyond that related to the type of intraocular lens implanted.
aVA Cooperative Studies Program Coordinating Center, Perry Point, Maryland
bUniversity of Maryland School of Medicine, Baltimore, Maryland
cDepartment of Ophthalmology VA Medical Center Long Beach, Long Beach, California
ABSTRACT