Purpose To assess and compare the results of primary and secondary implantation of flexible open-loop anterior chamber intraocular lenses (AC-IOLs).
Methods A series of 57 eyes of 56 patients with flexible AC-IOLs were reviewed in two groups. In group I (n = 35) an AC-IOL was implanted primarily, because of posterior capsule problems during extracapsular cataract extraction (ECCE), and in group II (n = 22) secondarily after intracapsular cataract extraction (ICCE). Follow-up was from 12 to 38 months.
Results Mean post-operative best-corrected visual acuity in group I was significantly lower (20/37.38) than that of group II (20/29.20) (p = 0.044). Best: corrected visual acuity of 20/40 or better was achieved in 19 of 29 eyes (65%) in group I, and in 16 of 21 eyes (76%) in group II. The difference was not statistically significant (p > 0.05). In group II 18 eyes (86%) maintained or improved visual acuity. In group I, 17 eyes (49%) had a total of 22 complications, while 7 eyes (32%) had 9 complications in group IP (p > 0.05).
Conclusions Flexible open-loop AC-IOLs are suitable for both primary and secondary implantation to correct aphakia. Secondary implantation of flexible open-loop AC-IOLs after ICCE seems to have a more favourable visual outcome and a lower complication rate than primary implantation in complicated ECCE cases.