Long-term results in complicated cataract similar with AC, scleral-fixated IOLs

This retrospective study found similar long-term visual outcomes and complications after primary anterior chamber (AC) or secondary scleral-fixated IOL implantation in consecutive complicated cataract surgeries with inadequate capsular support.

The authors followed for a mean of 64.1 months 89 eyes implanted with a primary ACIOL and 74 implanted with a secondary scleral-fixated IOL, all with inadequate capsular support.

Similar to the results of a previous report, there were more eyes with early postoperative complications after primary ACIOL implantation. The most common early complication was transient corneal edema, followed by retained lens material. 

Late complications did not differ between the groups, with no difference in the incidence of corneal decompensation following primary ACIOL (12.4%) and secondary scleral-fixated IOL (10.8%) implantation. Similar to previous studies, the most frequent late complication observed was persistently high IOP, with no difference between the groups. 

They note that primary ACIOL implantation allows immediate aphakic correction without prolonging the complicated operation extensively and recommend performing it when the expertise for a scleral-fixated IOL is not available or a patient cannot afford a second surgery. On the other hand, they say that secondary scleral-fixated IOL implantation allows better surgical planning in a more controlled situation.