Long term complications from extracapsular cataract surgery.

Long term follow up of extracapsular extraction showed visual results superior to those previously reported for intracapsular extraction. Ninety-six per cent of 197 eyes examined five years after extracapsular extraction with capsule supported lens implantation had a visual acuity of 6/12 or better. Of the 498 cases examined three years after surgery, including eyes without implants, 93 per cent had a visual acuity of 6/12 or better. Complications were rare provided the posterior capsule remained intact. Forty-five per cent of eyes without implants had required secondary capsulotomy within three years of surgery, compared with 11 per cent of eyes in which Binkhorst lenses had been used. Only 27 per cent of the eyes with Binkhorst lenses examined seven years after surgery were found to have required secondary capsulotomy. Opening of the capsule was seen to increase the risk of sight threatening complications, in particular of retinal detachment in high myopes. Implantation of posterior chamber lenses appeared to reduce the need for capsulotomy even further and it is suggested that their use in high myopia may help to lessen the chance of retinal detachment.