Results of intraocular lens implant surgery. The third Binkhorst medal lecture.

I compared an early series of 162 consecutive Copeland intraocular lens implants with a later series of 650 consecutive Binkhorst implants. Of the eyes with Copeland implants, 76.5% achieved 6/12 (20/40) or better visual acuity compared to 89.8% in the Binkhorst series. There was a striking difference in the incidence of clinically significant cystoid macular edema (less than 6/12 [20/40], visual acuity); 7.4% in the Copeland series and 1.4% in the Binkhorst series. I studied the Binkhorst series for visual acuity, causes of less than 6/12 (20/40) visual acuity, operative vitreous problems, additional surgery, secondary membranes, dislocations, and retinal detachment. A fluorescein angiographic study of 190 Binkhorst implants and 113 aphakic controls was done. There was a comparable incidence of cystoid macular edema in both groups at four, eight, and 16 to 24 months postoperatively. Extracapsular Binkhorst implants showed a lower incidence than intracapsular Binkhorst implants.