Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty

Gonnermann, Johannes; Torun, Necip; Klamann, Matthias K. J.; Maier, Anna-Karina B.; Sonnleithner, Christoph von; Joussen, Antonia M.; Rieck, Peter; Bertelmann, Eckart

doi:10.1007/s00417-012-2226-y

Cited by 29 publications

(25 citation statements)

References 22 publications

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“…Retropupillary implantation of a similar Verisyse ® iris claw lens after vitrectomy has also been reported 18–21. Although implanting the iris claw lens above the iris for aphakic eyes may decrease the endothelial cell count, in most studies using the retropupillary fixation technique, a significant effect was not found on the endothelial cell count, as in the present study 22,23…”

Section: Discussionsupporting

confidence: 69%

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Faria

Ferreira

Pinto

et al. 2016

IMCRJ

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BackgroundNowadays, dislocated intraocular lenses (IOLs) and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL) are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL.MethodsThis study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth.ResultsThe mean follow-up was 23 months (range: 6–48 months). The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1) retinal detachment was found in one patient, 2) corneal edema was found in three patients, 3) high intraocular pressure was observed in twelve patients, 4) subluxation of the IOL was observed in one patient, and 5) macular edema was found in three eyes.ConclusionThe results demonstrate that retropupillary ICIOL is an easy and effective method for the correction of aphakia in patients not receiving capsule support. The safety of this procedure must be interpreted in the context of a surgery usually indicated in complicated cases.

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Section: Discussionsupporting

confidence: 69%

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Faria

Ferreira

Pinto

et al. 2016

IMCRJ

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“…Several studies have indicated favourable visual outcomes and a low incidence of intraoperative and postoperative complications with aphakic iris-claw IOLs 5 6 14 16 22–24. These implants used to be positioned in the anterior chamber only but are more and more inserted retropupillary in recent years.…”

Section: Discussionmentioning

confidence: 99%

Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty

et al. 2014

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“…Several case series have demonstrated its safety and good visual results 4,6–8. The technique is simple, less time consuming, and has a lower postoperative complication rate than other techniques 9–11.…”

Section: Discussionmentioning

confidence: 94%

Retropupilar positioning of foldable iris-claw intraocular lens for correction of aphakia with no capsular support

Faria¹,

Ferreira²,

Gama³

et al. 2016

IMCRJ

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SummaryIris-claw intraocular lens (ICIOL) for aphakia needs a large 5.4 mm corneal incision for its implantation. The technique needs corneal suture, associated with some postoperative astigmatism. Foldable ICIOL is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated intraocular lens (IOL) and no capsular support. Dislocated IOL with its capsular bag was released with three-port, 23-gauge vitrectomy; placed in the anterior chamber; sliced; and extruded through a 3.2-mm corneal incision, where a foldable ICIOL was introduced and placed retropupillary. This technique achieved a stable fixation of the IOL. Retropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a polymethylmethacrylate (PMMA) ICIOL due to smaller corneal incision. The technique may be safe and easy to perform.PurposeThe purpose of this report was to describe the technique of retropupillary implantation of a foldable iris-claw intraocular lens (ICIOL) in a patient with dislocated intraocular lens (IOL) in mid vitreous cavity.MethodsFoldable ICIOL (Artiflex® Myopia Model 401) is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated IOL and no capsular support. The calculation was a −5.0 D IOL for retropupilar position, and a foldable ICIOL was introduced through a 3.2-mm corneal incision and placed retropupillary.ResultsThe technique was easy to achieve. IOL was properly positioned retropupillary and maintained stable. There was no ocular hypertension and no anterior chamber flare or iris atrophy.ConclusionRetropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a PMMA ICIOL due to smaller corneal incision. The technique may be safe and easy to perform.

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Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty

Abstract: Retropupillar iris-claw IOL during penetrating keratoplasty provides good visual outcomes with a favorable complication rate, and can be used for a wide range of indications in eyes without adequate capsule support.

Cited by 29 publications

References 22 publications

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty

Retropupilar positioning of foldable iris-claw intraocular lens for correction of aphakia with no capsular support

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