Posterior, anterior chamber IOLs produce similar visual outcomes after vitreous presentation

Posterior and anterior chamber IOLs, implanted after vitreous presentation during extracapsular cataract surgery, generate similar long-term visual acuity results, a prospective study found.

Ronald N. Gaster, MD, FACS, and Joseph F. Collins, ScD, compared visual outcomes between posterior chamber IOLs and anterior chamber IOLs implanted after vitreous presentation during extracapsular cataract surgery. The study included 438 patients treated at 19 Department of Veterans Affairs medical centers; 230 patients were randomly assigned to receive a posterior chamber IOL and 208 were assigned to receive an anterior chamber IOL, according to the study.

The study also included 143 patients who did not receive IOLs due to insufficient capsular support and 521 randomly selected nonvitreous presentation patients.

The researchers found no significant difference in the major outcome measure — best corrected visual acuity of 20/40 or better — between the posterior chamber IOL and anterior chamber IOL groups at up to 4 years follow-up. BCVA of 20/40 or better was achieved in 88.7% of posterior chamber IOL patients and 82.2% of anterior chamber IOL patients at 2 years, in 82.5% of posterior chamber IOL patients and 91.8% of anterior chamber IOL patients at 3 years and in 88.6% of posterior chamber IOL patients and 92.6% of anterior chamber IOL patients at 4 years, according to the study.

Patients who had insufficient capsular support had significantly worse BCVA or a trend toward worse BCVA than those in the other three groups at 2 and 4 years follow-up, the authors noted.

The study is published in the August issue of American Journal of Ophthalmology.