Iris-claw intraocular lens for aphakia: Can location influence the final outcomes?

J Cataract Refract Surg. 2018 Jul;44(7):818-826. doi: 10.1016/j.jcrs.2018.05.010.

Abstract

Purpose: To describe the demographic data, evaluate the long-term refractive and anatomical outcomes, and report the incidence of complications of anterior iris (prepupillary) and posterior iris (retropupillary) fixation of the Artisan aphakia iris-claw intraocular lens (IOL).

Setting: Complejo Hospitalario Universitario de Santiago de Compostela, Spain.

Design: Retrospective case series.

Methods: Patients who had iris-claw IOL implantation were divided into 2 groups: Group 1 (prepupillary) and Group 2 (retropupillary). The corrected distance visual acuity (CDVA), anatomical changes, endothelial cell count (ECC), presence of cystoid macular edema (CME), and operative and postoperative complications were determined.

Results: The study comprised 95 eyes of 95 patients. Fifty-seven patients had prepupillary implantation and 38 patients had retropupillary implantation. Indications for surgery were IOL luxation or subluxation (n = 24), lens luxation or subluxation (n = 17), trauma (n = 15), aphakia (n = 30), and other (n = 9). The CDVA improved significantly in both groups and there were no differences between them. A significant ECC reduction was observed in both groups, with no differences between them. The incidence of CME was 16.1% (21.8% in the prepupillary group and 7.9% in the retropupillary group at 3 months and 8 months, respectively), although the difference was not statistically significant. Other postoperative complications were rare and no differences were found between groups.

Conclusions: Irrespective of location, the iris-claw IOL provided good visual outcomes with few complications. However, prepupillary IOL implantation seemed to contribute to greater endothelial cell loss and earlier onset of CME.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aphakia, Postcataract / surgery*
  • Corneal Endothelial Cell Loss / diagnosis
  • Female
  • Humans
  • Iris / surgery*
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prosthesis Design
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Visual Acuity / physiology