Comparison of Outcomes of Primary Anterior Chamber Versus Secondary Scleral-Fixated Intraocular Lens Implantation in Complicated Cataract Surgeries

• Published in: American journal of ophthalmology Vol. 159; no. 2; pp. 221 - 226.e2
• Main Authors: Chan, Tommy C.Y, Lam, Jasmine K.M, Jhanji, Vishal, Li, Emmy Y.M
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2015; Elsevier Limited
• Subjects: Age; Aged; Aged, 80 and over; Anterior Chamber - surgery; Cataract - complications; Cataract Extraction; Cataracts; Confidence intervals; Demographics; Eye surgery; Female; Glaucoma; Humans; Lens Implantation, Intraocular - methods; Lenses, Intraocular; Male; Ophthalmology; Polymethyl methacrylate; Postoperative Complications; Regression analysis; Retrospective Studies; Sclera - surgery; Surgery; Surgical techniques; Transplants & implants; Treatment Outcome; Visual Acuity - physiology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2014.10.016

Purpose To compare the outcome of primary anterior chamber vs secondary scleral-fixated intraocular lens (IOL) implantation in complicated cataract surgeries. Design Retrospective, comparative study. Methods A consecutive series of complicated cataract surgeries with primary anterior chamber (ACIOL) or secondary scleral-fixated IOL implantation from January 1, 2004 to December 31, 2009 was analyzed. Main outcome measures included the postoperative best-corrected visual acuity (BCVA) and postoperative complications. Results There were 89 eyes in the primary ACIOL group and 74 eyes in the secondary scleral-fixated IOL group. The mean follow-up duration was 64.1 ± 36.7 months. The mean postoperative logarithm of minimal angle of resolution (logMAR) BCVA at 1 year was 0.32 ± 0.54 and 0.34 ± 0.21 in the primary ACIOL group and the secondary scleral-fixated IOL group, respectively ( P  = .734). The mean latest logMAR BCVA was 0.68 ± 0.54 and 0.61 ± 0.47 in the primary ACIOL group and the secondary scleral-fixated IOL group, respectively ( P  = .336). The primary ACIOL group had more early postoperative complications ( P < .001). No difference in late postoperative complications was observed between the 2 groups ( P  = .100). Regression analysis showed that primary ACIOL and secondary scleral-fixated IOL implantation had similar latest postoperative logMAR BCVA ( P  = .927), while the presence of late complications was associated with a worse final visual outcome ( P  = .000). Conclusions This study shows that there are no long-term differences in the visual outcomes and complication profiles after primary ACIOL or secondary scleral-fixated IOL implantation in a complicated cataract operation when capsular support is inadequate.