Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis

PURPOSE: To compare the visual outcomes and prevalence of long-term complications in patients with quiescent uveitis after phacoemulsification with traditional in-the-bag intraocular lens (IOL) implantation versus primary or secondary anterior chamber (AC) IOL implantation due to inadequate capsule support. SETTING: Single-center private practice. DESIGN: Retrospective observational cohort study. METHODS: Patients with quiescent uveitis who had cataract surgery with subsequent AC IOL implantation were identified through an electronic medical record database. They were age matched with patients with uveitis who had conventional placement of a posterior chamber (PC) IOL. The rate of postoperative complications and corrected distance visual acuity (CDVA) were reviewed preoperatively and 1, 3, and 6 months and 1, 2, 3, and 4 years postoperatively. RESULTS: The incidence of postoperative complications was not statistically different for any criterion except posterior capsule opacification development in the PC IOL cohort (relative risk, 0.071). The mean follow-up was 36.11 months +/- 17.3 (SD) in the AC IOL group and 53.72 +/- 20.4 months in the PC IOL group. The mean preoperative CDVA was 1.49 +/- 1.07 logMAR in the AC IOL group and 0.5 +/- 0.26 logMAR in the PC IOL group. Both groups had a significant improvement in CDVA visual acuity 3 years postoperatively (P=.001 and P=.010 respectively). CONCLUSIONS: In uveitic eyes with inadequate capsule support, AC IOL implantation was safe and effective in providing satisfactory improved CDVA without a significant increase in long-term complications compared with eyes that had PC IOL placement.