Outcomes of anterior chamber intraocular lenses placed by surgeons in training

J Cataract Refract Surg. 2015 Oct;41(10):2102-6. doi: 10.1016/j.jcrs.2015.11.006.


Purpose: To evaluate risk factors and outcomes of unplanned, primary anterior chamber intraocular lenses (AC IOLs) placed by surgeons in training.

Setting: Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.

Design: Retrospective case series.

Methods: Cataract surgeries performed primarily by a resident surgeon that resulted in an unplanned AC IOL were included. Cases that had concomitant retinal surgery were excluded. Preoperative data gathered included corrected distance visual acuity (CDVA), intraocular pressure (IOP), and ocular comorbid conditions. Operative times and complications requiring an AC IOL were assessed. Postoperative CDVA, IOP, corneal edema, persistent intraocular inflammation, macular edema, and need for additional surgery were analyzed for the first postoperative year.

Results: Twenty-two eyes were included. The mean preoperative CDVA was 1.24 logMAR ± 0.92 SD and the mean preoperative IOP was 17.55 ± 3.88 mm Hg. The mean operative time was 103 ± 30 minutes. The most common operative complications necessitating an AC IOL were 7 (32%) capsule tears with vitreous prolapse requiring anterior vitrectomy and 7 (32%) capsule tears, zonular dehiscence, and vitreous prolapse requiring anterior vitrectomy. By the first postoperative year, the mean visual acuity was 0.40 ± 0.58 logMAR and the IOP was 15.05 ± 6.01 mm Hg. The most common complications 1 year postoperatively included persistent macular edema (23%) and need for additional surgery (18%).

Conclusion: This group of patients who received unplanned primary AC IOLs by surgeons in training had improved visual acuity and well-controlled IOP 1 year postoperatively.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Aged
  • Anterior Chamber / surgery*
  • Cataract Extraction*
  • Clinical Competence
  • Corneal Edema / physiopathology
  • Education, Medical, Graduate / standards*
  • Female
  • Humans
  • Inflammation / physiopathology
  • Internship and Residency*
  • Intraocular Pressure / physiology
  • Intraoperative Complications
  • Lens Implantation, Intraocular*
  • Macular Edema / physiopathology
  • Male
  • Ophthalmology / education*
  • Postoperative Complications
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Visual Acuity / physiology