title: Outcomes in patients having vitreous presentation during cataract surgery who lack capsular support for a nonsutured PC IOL.
abstract: OBJECTIVE
  The study's purpose was to determine the effect that lack of capsular support for a nonsutured posterior chamber (PC) intraocular lens IOL has on 1-year postoperative vision in patients suffering vitreous presentation (VP) during extracapsular cataract surgery.
  
  
  METHODS
  The study was a prospective, long-term clinical trial.
  
  
  METHODS
  The study was conducted at 19 Department of Veterans Affairs medical centers. Patients having VP during cataract surgery with sufficient capsular support for a nonsutured PC IOL were randomized to receive either a PC IOL (230 patients) or an anterior chamber (AC) IOL (208 patients). Patients having insufficient capsular support (ICS) for a nonsutured PC IOL (143 patients) were prospectively followed in the same fashion. Best-corrected visual acuity (BCVA) at 1 year was obtained by a masked, certified examiner.
  
  
  RESULTS
  The ICS group had considerably fewer patients with BCVA of 20/40 or better at 1 year (P < .0001) than the randomized PC IOL group (66.7% vs 91.1%) with a trend (P = .04) for having fewer patients than the randomized AC IOL group (66.7% vs 79.0%). The ICS group had significantly poorer rating of vision at 1 year by study raters, and the patients themselves than either of the randomized VP groups.
  
  
  CONCLUSIONS
  The lack of capsular support for the placement of a nonsutured PC IOL after VP during extracapsular cataract surgery or the severity of the complication of VP associated with lack of capsular support would appear to cause visual problems beyond that related to the type of intraocular lens implanted.
authors.affiliation: VA Cooperative Studies Program Coordinating Center, VA Medical Center, PO Box 1010, Perry Point, MD 21902, USA. joseph.collins2@va.gov
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Collins
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Gaster
authors.forename: William F
authors.initials: WF
authors.lastname: Krol
mesh_terms: D000368:Aged; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*