Artisan-style iris-claw intraocular lens implantation in patients with uveitis

Negretti, Guy S.; Chan, Weng Onn; Pavésio, Carlos; Muqit, Mahiul M. K.

doi:10.1016/j.jcrs.2019.07.032

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…However, in one report including a case series of 11 patients with a history of uveitis, it was concluded that it was safe to use a prepupillary iris‐claw lens (Negretti et al. 2019). Although our search did not return any literature specifically focused on the retropupillary placement of iris‐claw lenses in eyes with uveitis, the location—that is, anterior or posterior to the iris—is presumably irrelevant in such cases.…”

Section: Indications For Surgerymentioning

confidence: 99%

“…Despite the lack of clear recommendations for using iris-claw IOLs in eyes with uveitis, one may speculate fixating the haptics to the iris can contribute to a prolonged inflammatory response in such eyes, and in most studies, eyes with active uveitis have been excluded (Baykara et al 2007;Helvaci et al 2016;Kristianslund et al 2017c). However, in one report including a case series of 11 patients with a history of uveitis, it was concluded that it was safe to use a prepupillary iris-claw lens (Negretti et al 2019). Although our search did not return any literature specifically focused on the retropupillary placement of iris-claw lenses in eyes with uveitis, the location-that is, anterior or posterior to the iris-is presumably irrelevant in such cases.…”

Section: Uveitismentioning

confidence: 99%

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Implantation of retropupillary iris‐claw lenses: A review on surgical management and outcomes

Drolsum

Kristianslund

2021

Acta Ophthalmologica

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Iris-claw lenses have gained increasing popularity over the last years and are by many surgeons regarded as viable options in eyes with insufficient capsular or zonular support. The iris-claw lens has two haptics with fine fissures for folding (enclavating) the mid-peripheral part of the iris stroma and can either be placed in front of or posterior to the iris. In particular, the retropupillary implantation has been increasingly chosen probably due to having an anatomical position similar to that of the crystalline lens. The present review is based on a literature review and also on the authors' clinical experience with this lens, and it focuses on surgical techniques and outcomes especially related to the characteristics of this lens, having haptics with claws that fixate the lens to the posterior iris. Implanting retropupillary iris-claw lenses has a relatively short learning curve, and there are only few complications reported during surgery. Retropupillary iris-claw lenses have demonstrated generally favourable efficiency and safety. However, the outcomes are probably more influenced by the reason for surgery and eye comorbidity than the lens itself. Albeit seldom reported, the postoperative complications have mostly been related to atrophy of the iris at the site of the haptics, or IOL decentration or disenclavation of one of the haptics. To date, however, there are few randomized clinical trials comparing this lens to other lens alternatives in eyes exhibiting insufficient capsular or zonular support for placing the lens in the ciliary sulcus. In the future, prospective studies with large samples should be performed to gain insights into the long-term safety of retropupillary placed iris-claw lenses, and for comparisons with the various other techniques of lens fixation.

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Section: Indications For Surgerymentioning

confidence: 99%

Section: Uveitismentioning

confidence: 99%

Implantation of retropupillary iris‐claw lenses: A review on surgical management and outcomes

Drolsum

Kristianslund

2021

Acta Ophthalmologica

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“…Cases were identified using our electronic patient record with external validation using medical records. Patients with <2 months of follow up were excluded from our analysis as were patients with a history of uveitis, outcomes from whom have been reported elsewhere [10]. The study was approved by the Institutional Review Board at Moorfields Eye Hospital (CA18/VR/114).…”

Section: Methodsmentioning

confidence: 99%

Artisan iris-claw intraocular lens implantation in vitrectomised eyes

Negretti

Chan

Muqit

2020

Eye

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Objectives To present the visual acuity (VA) results and complication rates following Artisan intraocular lens (IOL) insertion in vitrectomised eyes. Methods Outcome data were collected for all vitrectomised patients who had undergone Artisan IOL insertion between January 2014 and May 2019 at Moorfields Eye Hospital. All those with follow-up greater than 2 months were included in the analysis.Results Sixty-nine eyes from 61 patients were included. Average follow up was 2 years. Fifty-five (80%) eyes had at least one ocular comorbidity prior to Artisan IOL insertion. At final follow up 46 (67%) eyes had best-corrected VA better than 6/12. Sixty-three eyes (91%) either gained or maintained VA. Mean post-operative spherical equivalent was −0.2D. Two (3%) lenses became de-enclavated requiring further surgery. Two (3%) eyes developed acute post-operative cystoid macular oedema. Two (3%) required additional topical IOP-lowering therapy to their pre-operative glaucoma regimen. One eye had mild corneal oedema, which persisted for 1 year following surgery and subsequently resolved. Conclusions Artisan IOL insertion is a safe and effective option for the surgical correction of aphakia in vitrectomised eyes lacking capsular support. Refractive results comparable to posterior chamber IOL placement can be achieved with these lenses.

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“…Several studies have reported on the safety and efficacy of multiple methods of IOL implantation in patients with inadequate capsular support. [ 4 5 6 7 8 9 10 ] These include different methods of scleral fixation, iris fixation, or anterior chamber IOL implantation. However, there is a lack of information on the use of sulcus fixation of three-piece IOLs in patients with exfoliation.…”

mentioning

confidence: 99%

Three-piece intraocular lens in the sulcus with optic capture in patients with mild to moderate zonular weakness in exfoliation

Bhaskaran

Narayanan

Balamurali

2022

Indian Journal of Ophthalmology

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Purpose: To study the use of sulcus placement of a 3-piece intraocular lens (IOL) with optic capture in patients with exfoliation with zonular weakness. Methods: Data on all exfoliation patients who had direct or indirect evidence of zonular weakness and had a 3-piece IOL implanted in the sulcus with optic capture over a 5-year period between January 2017 and January 2022 were included in this retrospective case series. Results: The study comprised of 35 eyes of 35 patients. The mean age at surgery of the 20 male and 13 female patients was 75.21 years ± 5.74 (standard deviation (SD)). The mean pupillary diameter was 5.77 ± 2.23 mm (range: 10 to 3 mm). A capsular tension ring (CTR) was used in 17 cases and iris hooks as a pupil-expanding device were used in 15 cases. No patients had an increase in inflammation after surgery and there were no late subluxation or dislocation of “in the bag” posterior chamber IOL or major complications. There was a significant improvement in visual acuity. Conclusion: The sulcus placement of 3-piece IOL with optic capture is the ideal technique in patients with clinical or intraoperative evidence of mild to moderate zonular weakness. It may also be more appropriate in relatively younger patients (in the fifties or sixties) with exfoliation with no overt zonulopathy to prevent late subluxation or dislocation of “in the bag” IOL.

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Artisan-style iris-claw intraocular lens implantation in patients with uveitis

Cited by 6 publications

References 9 publications

Implantation of retropupillary iris‐claw lenses: A review on surgical management and outcomes

Implantation of retropupillary iris‐claw lenses: A review on surgical management and outcomes

Artisan iris-claw intraocular lens implantation in vitrectomised eyes

Three-piece intraocular lens in the sulcus with optic capture in patients with mild to moderate zonular weakness in exfoliation

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