A prospective trial was set up to compare pseudoaccommodation. Fifty patients were randomized into two groups. Group 1 comprised 25 patients who had a monofocal implant and a postoperative refractive aim of -0.3 to -1.3 diopter (D) spherical equivalent and an astigmatic component between 1.0 and 1.75 D cylinder. Group 2 comprised 25 patients who had a new multizone refraction style multifocal implant and a postoperative refractive aim of -0.5 to +0.5 D spherical equivalent and an astigmatic component of less than 1.0 D cylinder. Eighty percent of postoperative refractions in Group 1 and 88% in Group 2 were within 0.5 D either side of the refractive aim. Forty-eight percent of Group 1 and 72% of Group 2 could see both 20/40 and J3 unaided. Four percent of Group 1 and 84% of Group 2 could read J2 with the distance correction. Sixteen percent of Group 1 and 48% of Group 2 could read J2 at 25 cm unaided (P = .03). Sixty-four percent of Group 1 and 88% of Group 2 stated they could manage daily activities without glasses. However, 88% of Group 1 and 52% of Group 2 requested reading glasses to improve clarity of the smallest print.

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During the first half of the 20th century there was a strong controversy over the route for removal of an intraocular foreign body (IOFB) lying in the posterior segment of the eye. In the early years the anterior route was substantially the method of choice (Barkan and Barkan, 1927;Verhoeff, 1932 I961-1970, further details of which are published in the accompanying paper (Percival, I972). Double perforations have been excluded, and when five cases in which the site of the foreign body was either in the optic nerve or never known and two cases of transfixion are also excluded, there remain I 14 vitreous or preretinal foreign bodies and 39 foreign bodies clinically impacted in the retina or choroid. This group of I53 IOFBs, fifteen of which were non-magnetic, form the basis for the following study.Route of extraction The majority of foreign bodies were removed by the posterior route, and Table I compares the incidence of complications related to three different methods. As large foreign bodies are naturally associated with a high complication rate, all IOFBs known to be over 5 cu. mm. in size are excluded from this Table. In order that the methods should be comparable, all foreign bodies removed through the wound of entry, whether corneal or scleral, are also excluded. This tends to eliminate complications arising at the time of injury when the perforating wound was large and the ocular damage that much greater.The anterior route method involved drawing the foreign body into the anterior chamber with a magnet and extraction through a keratome incision. The high incidence of complications and poor prognosis is striking: even retinal detachment occurred twice as frequently as after posterior route extractions.