The posterior iris-claw lens outcome study: 6-month follow-up

Abstract

Purpose:The purpose of this study was to evaluate functional and anatomical outcomes of posterior iris-claw intraocular lens (IOL) implant for correction of aphakia in eyes with inadequate capsular support.Materials and Methods:Prospective case series of 108 aphakic eyes with inadequate capsular support which underwent posterior iris-claw IOL with a 6-month follow-up period was conducted. The cases belonged to two clinical settings: elective secondary implantation and those with intraoperative posterior dislocation of cataractous lens or IOL. Main outcome measures were visual acuity, anterior chamber reaction, stability of IOL, endothelial cell count, intraocular pressure (IOP), and cystoid macular edema (CME).Results:The mean best-corrected visual acuity was LogMAR 0.25. None had chronic anterior chamber inflammation. The mean difference in central endothelial counts before surgery and 1 month after surgery was 104.21 cell/mm2 (4.92%). There was no statistically significant difference in central endothelial cell count at 1 and 6 months (P = 0.91) and also in the central macular thickness at preoperative and after 6 months suggestive of CME (P = 0.078). Three eyes had raised IOP which were managed with neodymium-doped yttrium aluminum garnet laser peripheral iridotomy. There were no IOL dislocations or other adverse events in our series.Conclusion:Posterior chamber iris-claw lenses are a good option in eyes with inadequate posterior capsular support. Chronic inflammation, poor lens stability, or significant central endothelial cell loss was not observed during the 6-month follow-up period.

Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation

“…Concerning safety, CMT, ECD loss, and type and percentage of postoperative complications were comparable between the groups. At the end of follow-up, the CMT was not significantly different from the preoperative value in either group, which was consistent with previous studies [ 11 , 12 ]. We analyzed ECD loss at 1 and 12 months; loss at the first time point is assumed to mainly reflect intraoperative cellular loss, while ECD loss occurring between 1 month and 12 months is attributable to the presence of the IOL.…”

“…Iris-claw IOLs can also be securely fixed to the posterior surface of the iris, to maintain the physiological position of the diaphragm in the posterior chamber (PC) of the eye and thus reduce the potential for the complications associated with AC IOLs. Many investigators have reported relatively large series, both prospective and retrospective, demonstrating the midterm safety and efficacy of this procedure [ 9 – 12 ]. Both AC and PC iris-claw IOLs were also found to be safe and effective for visual rehabilitation in young patients [ 13 , 14 ].…”

Komparative Analyse von Sicherheits- und Funktions-Outcomes der anterioren versus retropupillaren Irisklauen-IOL-Implantation

“…Hinsichtlich der Sicherheit waren ZND, EZD-Verlust sowie Art und Häufigkeit postoperativer Komplikationen in beiden Gruppen vergleichbar. Am Ende des Nachbeobachtungszeitraums unterschied sich die ZND in beiden Gruppen nicht signifikant vom präoperativen Wert, was sich mit den Ergebnissen früherer Studien deckt [11,12]. Wir analysierten den EZD-Verlust nach 1 und nach 12 Monaten; vom ersteren Wert wird angenommen, dass er hauptsächlich den intraoperativen Zellverlust widerspiegelt, während der EZD-Verlust zwischen dem ersten und dem zweiten Zeitpunkt auf das Vorhandensein der IOL zurückgeführt wird.…”

“…Irisklauen-IOL können ebenso sicher an der posterioren Fläche der Iris fixiert werden, um die physiologische Position des Diaphragmas in der Hinterkammer (HK) aufrechtzuerhalten und so das Komplikationsrisiko zu verringern, das mit VK-IOL assoziiert ist. Viele Autoren haben über recht große Fallserien berichtet, sowohl prospektiv als auch retrospektiv, und haben damit die mittelfristige Sicherheit und Wirksamkeit des Eingriffs belegt [9,10,11,12]. Sowohl VK- als auch HK-Irisklauen-IOL haben sich als sicher und wirksam für die visuelle Rehabilitation bei jungen Menschen erwiesen [13,14].…”

Morphofunctional changes and complications after out-of-the-bag intraocular lens implantation

“…Результаты иридоангиографии после имплантации современных моделей ирис-кло линз показывают незначительные изменения в радужной оболочке по сравнению с переднекамерной, зрачковой и шовной ирис-фиксацией. При этом ретропупиллярная имплантация ирис-кло ИОЛ способствует значительному уменьшению частоты развития и степени тяжести данного осложнения [28][29][30].…”