ArticleIris-claw intraocular lenses to correct aphakia in the absence of capsule supportDe Silva, Samantha R. MRCOphth∗; Arun, Kikkeri FRCS; Anandan, Maghizh FRCOphth; Glover, Nicholas FRCOphth; Patel, Chetan K. FRCOphth; Rosen, Paul FRCOphth Author Information From the Oxford Eye Hospital (De Silva, Arun, Patel, Rosen), Oxford, the Royal Derby Hospitals NHS Trust (Anandan), Derby, and Queen Elizabeth Hospital (Glover), Birmingham, United Kingdom ∗Corresponding author: Samantha R. De Silva, MRCOphth, Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom. E-mail: [email protected] Submitted: December 21, 2010. Final revision submitted: March 22, 2011. Accepted: March 23, 2011. Presented in part at the XXVIII Congress of the European Society of Cataract and Refractive Surgeons, Paris, France, September 2010. SymbolFirst author:Symbol: No Caption available.Samantha R. De Silva, MRCOphth Oxford Eye Hospital, Oxford, United Kingdom Journal of Cataract & Refractive Surgery: September 2011 - Volume 37 - Issue 9 - p 1667-1672 doi: 10.1016/j.jcrs.2011.03.051 Buy Metrics Abstract PURPOSE: To evaluate the indications, postoperative visual efficacy, and complication rate after intraocular implantation of an iris-claw aphakic intraocular lens (IOL). SETTING: Oxford Eye Hospital, Oxford, United Kingdom. DESIGN: Case series. METHODS: This chart review comprised eyes with no capsule support that had anterior iris-fixation IOL implantation for aphakia between 2001 and 2009. RESULTS: The study comprised 116 eyes (104 patients). Iris-claw IOLs were inserted during primary lens surgery in 18 eyes (15.5%), during an IOL exchange procedure for dislocated posterior chamber IOLs in 19 eyes (16.4%), and as a secondary procedure in 79 eyes (68.1%). The mean follow-up was 22.4 months (range 3 to 79 months). The final corrected distance visual acuity (CDVA) was 6/12 or better in 68.9% of all eyes and in 47 of 53 eyes (88.7%) with no preoperative comorbidity. Complications included wound leak requiring resuturing in 2.6% of eyes, postoperative intraocular pressure rise in 9.5% of eyes (glaucoma escalation 0.8%), and cystoid macular edema in 7.7% of eyes (0.8% chronic). Iris-claw IOL subluxation occurred in 6.0% of eyes from 5 days to 60 months postoperatively; all the IOLs were repositioned. Corneal decompensation occurred in 1.7% of eyes; 0.8% had retinal detachments. CONCLUSIONS: Iris-claw IOL implantation for aphakia gave a good visual outcome and can be used for a wide range of indications. Postoperative complication rates were comparable to, if not better than, those with conventional anterior chamber IOLs. Correct implantation technique is critical in avoiding postoperative IOL subluxation. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2011 by Lippincott Williams & Wilkins, Inc.
