AIM: To compare the clinical outcome of anterior chamber intraocular lens(IOL)at Ⅰ stage versus sclera-fixed IOL at Ⅱ stage in complicated cataract surgeries with inadequate capsular support.

METHODS: Complicated cataract surgeries with anterior chamber IOL(ACIOL)or scleral-fixated IOL implantation from January 2003 to December 2014 when capsular support was inadequate were included and analyzed. Postoperative best-corrected visual acuity(BCVA)were compared. Postoperative complications were recorded and analyzed.

RESULTS: Totally 84 eyes and 79 eyes were included in the ACIOL group and in the scleral-fixated IOL group, respectively. The mean postoperative logarithm of minimal angle of resolution(LogMAR)BCVA at 1a was 0.30±0.64 and 0.33±0.34 in the ACIOL group and the scleral-fixated IOL group, respectively(t=0.407, P=0.712). The mean latest LogMAR BCVA was 0.67±0.55 and 0.62±0.50 in the primary ACIOL group and the secondary scleral-fixated IOL group, respectively(t=0.225, P=0.545). There were more early postoperative complications in the ACIOL group(χ²=14.613, P<0.001). No difference in late postoperative complications was found between the two groups(χ²=0.231, P=0.267). Regression analysis suggested that ACIOL and scleral-fixated IOL implantation had similar latest postoperative LogMAR BCVA(t=0.397, P=0.957); however the existence of late complications were related with a worse final visual outcome(t=22.156,P<0.001).

CONCLUSION: The long-term differences in the visual outcomes and complication profiles after ACIOL at Ⅰ stage or scleral-fixated IOL implantation at Ⅱ stage in a complicated cataract operation are not found when capsular support is inadequate.