The effect of vitreous presentation during extracapsular cataract surgery on the postoperative visual acuity at one year

Am J Ophthalmol. 2004 Oct;138(4):536-42. doi: 10.1016/j.ajo.2004.04.050.


Purpose: 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.

Design: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Cataract Extraction*
  • Eye Diseases / complications*
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications*
  • Lens Implantation, Intraocular
  • Postoperative Period
  • Prospective Studies
  • Vision Disorders / etiology
  • Visual Acuity / physiology*
  • Vitreous Body / pathology*