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Jonathan N. Kruh, Ana M. Suelves, C Stephen Foster; Long Term Complications and Visual Outcomes of Anterior Chamber versus Posterior Chamber Intraocular Lens Implants after Phacoemulsification in Patients with Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6687.
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To analyze the visual outcomes and long-term complication rates in patients with quiescent uveitis after having had phacoemulsification with subsequent placement of either an anterior chamber or posterior chamber intraocular lens implant.
This is a retrospective cohort study, which includes the analysis of 36 uveitic eyes that underwent phacoemulsification and lens implantation between October 2005 and October 2010.The 2 cohorts were defined based on their past ocular history of having had phacoemulsification surgery with placement of either an anterior chamber intraocular lens (ACIOL) or a posterior chamber intraocular lens (PCIOL). Each group included 18 eyes from 18 different patients, and was age-matched. Baseline past ocular history, postoperative complications and visual acuity of both groups were compared. SPSS 15.0 was used for the statistical analysis.
Average follow up was 36.11 months+/- 17.3 in the AC-IOL group and 53.72 months +/- 20.4 in the PC-IOL group (p=0.047, paired Wilcoxon test). No statistical differences were noted in baseline characteristics (sex, race, uveitis localization and etiology) between both groups.Patients with PCIOL implants had a greater risk for developing posterior capsule opacification (odds ratio: 0.071; 95% CI: 0.010; 0.488). A higher risk of early rise of intraocular pressure, deposits on lens, reactivation of uveitis and need for lens explantation was observed in the AC-IOL group, but these differences were not statistically significant. The mean preoperative logMAR best corrected visual acuity (BCVA) was 1.49+/- 1.07 in the AC-IOL group and 0.5+/- 0.26in the PC-IOL group. Both groups had a significant improvement of visual acuity after surgery (p< 0.01).
AC-IOL implantation due to lack of capsular support in uveitic eyes was well tolerated with no statistically significant increase in the long-term complication rate. Both groups had a significant improvement in BCVA. Posterior chamber implants had a significantly higher risk for the development of posterior capsule opacification.
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