The effect of vitreous presentation during extracapsular cataract surgery on the postoperative visual acuity at one year.
OBJECTIVE
The purpose of this study was to determine the effects that vitreous presentation (VP) during extracapsular cataract surgery has on patients' 1-year postoperative vision.


METHODS
The study was a prospective, long-term, clinical trial.


METHODS
The study took place at 19 Department of Veterans Affairs medical centers. Patients having VP during cataract surgery and receiving a posterior chamber (PC) intraocular lens (IOL) (230 patients) were prospectively compared with a 5% random sample of nonvitreous presentation (NVP) cataract surgery patients (521 patients). Best-corrected visual acuity (BCVA) at 1 year was obtained by a masked, certified examiner.


RESULTS
There was no statistical difference (P = .089) between the VP patients receiving PC IOL and the NVP patients in percentage of patients having BCVA of 20/40 or better at 1 year (91.1% vs 94.9%). There were significantly more PC IOL VP patients than NVP patients with BCVA of 20/50 or worse at some time during the first postoperative year (21.6% vs 10.9%; P = .0003), significantly fewer with BCVA of 20/20 or better at 1 year (27.8% vs 38.8%; P = .013), and significantly more with cystoid macular edema (11.5% vs 3.6%; P = .0002), retinal detachment (4.3% vs 0.2%; P = .0002), and uveitis (3.4% vs 0.6%; P = .012). The NVP patients rated their vision as very good or excellent significantly more often than the VP patients (71% vs 58%; P = .025).


CONCLUSIONS
Vitreous presentation during extracapsular cataract surgery leads to somewhat worse overall outcomes in patients, although the majority of patients with VP do reasonably well.
Collins
Joseph F
JF
VA Medical Center, Perry Point, MD 21902, USA. joseph.collins2@med.va.gov <joseph.collins2@med.va.gov>
Krol
William F
WF
Kirk
Gail F
GF
Gaster
Ronald N
RN
D000368:Aged; D002387:Cataract Extraction; D005128:Eye Diseases / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D011184:Postoperative Period; D011446:Prospective Studies; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000473:pathology*