Anterior chamber and sutured posterior chamber intraocular lenses in eyes with poor capsular support
Accepted 5 October 2004.
Purpose
To compare the clinical outcomes and complications of patients who had surgical placement of anterior chamber (AC IOLs) and sutured posterior chamber intraocular lenses (PC IOLs) after cataract surgery resulting in poor capsular support.
Setting
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida.
Methods
A retrospective interventional comparative case series of 181 eyes of 181 patients that had implantation of an intraocular lens with inadequate capsular support was conducted. A chart review of all patients that had implantation of AC IOLs or sutured PC IOLs at a tertiary care eye hospital between 1995 and 2001 was conducted.
Results
Outcome measures included final best-corrected visual acuity, spherical equivalent, and postoperative complications (pseudophakic bullous keratopathy, elevated intraocular pressure [IOP] inflammation, retinal detachment, suture erosion, cystoid macular edema). Of 702 charts reviewed, 181were found to fit inclusion and exclusion criteria. The postoperative complication risk ratio was 0.80 (95% confidence interval [CI]: 0.52–1.23) for AC IOLs compared with PC IOLs. The most common complication experienced by patients having implantation of either lens type was elevated IOP (AC IOL: 38%; PC IOL: 42%). The incidence of other complications was similar between the groups. Best-corrected visual acuity was similar; however, final spherical equivalent trended toward more myopic values in the PC IOL group (−0.82 ± 1.67 for AC IOL versus −1.32 ± 2.12 for PC IOL).
Conclusions
The findings suggest that no significant differences in outcome exist when comparing AC IOLs to sutured PC IOLs in complicated cataract extraction with poor capsular support. Recent advances in AC IOL design have yielded lenses that provide a safe, effective alternative to sutured PC IOLs.
From the Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
Reprint requests to Donald L. Budenz, MD, Bascom Palmer Eye Institute, 900 N.W. 17th Street, Miami, FL 33136.
Presented in part at the American Society of Cataract and Refractive Surgeons, May 2001, San Diego, California.
Supported by an unrestricted grant from Research to Prevent Blindness, New York, New York.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT