A comparion of anterior chamber and poterior chamber intraocular lene after vitreou preentation during cataract urgery: the Department of Veteran Affair Cooperative Cataract tudy

Purpoe To compare the efficacy and afety of anterior chamber (AC) intraocular lene (IOL) and poterior chamber (PC) IOL implanted after vitreou preentation during extracapular cataract extraction (ECCE). Deign The tudy wa a propective, long-term, randomized clinical trial conducted at 19 Department of Veteran Affair medical center acro the United tate. Method There were 438 eye (438 patient) that met preliminary eligibility criteria, uffered vitreou preentation during ECCE (phacoemulification or claical extracapular technique), and had ufficient capular upport for a PC IOL without uture after anterior vitrectomy randomized to either a PC IOL (230 patient) or an AC IOL (208 patient). Patient were examined at 3, 6, and 12 month pot-urgery and yearly thereafter. Minimum follow-up wa 1 year. The primary outcome meaure of bet-corrected viual acuity at 1 year wa obtained by a maked certified examiner. Reult More PC IOL patient (91%) achieved viual acuity of 20/40 or better at 1 year than AC IOL patient (79%), a highly ignificant difference (P = .003). There wa no ignificant difference between the two group for patient’ rating of viion or advere event. Over 84% of the PC IOL patient and over 77% of the AC IOL patient rated their viion a good or better at 1 year a oppoed to only 7% giving uch rating before urgery. For at leat one rating period during the firt year, 13.2% of the combined tudy patient had cytoid macular edema, 8.5% had poterior capule opacification, 5.7% had glaucoma, and 3.7% had retinal detachment. Concluion In the preence of ufficient capular upport, a PC IOL hould be implanted after vitreou preentation during ECCE