Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations
PURPOSE To evaluate the indications, visual outcomes, and complication rate after implantation of a posterior chamber iris-claw aphakic intraocular lens (IOL). SETTING Department of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany. DESIGN Retrospective case series. METHODS Eyes without adequate capsule support had posterior chamber iris-claw aphakic IOL implantation (Verisyse/Artisan) between 2005 and 2010. RESULTS The study comprised 137 eyes (126 patients). The mean follow-up was 5 months (range 1 to 48 months). The IOLs were inserted during primary lens surgery in 10 eyes (7.3%), during an IOL exchange procedure for dislocated posterior chamber IOLs in 95 eyes (69.4%), and as a secondary procedure in 32 aphakic eyes (23.3%). The final mean corrected distance visual acuity (CDVA) (0.38 ± 0.31 [SD] logMAR) was significantly better than preoperatively (0.65 ± 0.58 logMAR) (P < .05). In 128 eyes (93.4%), postoperative refractive errors were within ±2.00 diopters (D) of emmetropia. Complications included slight temporary pupil ovalization in 34 eyes (24.8%), cystoid macular edema in 12 eyes (8.7%), hyphema in 3 eyes (2.1%), early postoperative hypotony in 7 eyes (5.1%) and elevated intraocular pressure in 6 eyes (4.3%), chronic uveitis in 1 eye (0.7%), toxic anterior segment syndrome in 1 eye (0.7%), and endophthalmitis in 1 eye (0.7%). Iris-claw IOL disenclavation occurred in 12 eyes (8.7%); all IOLs could be easily repositioned. CONCLUSION The retropupillary iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used for a wide range of indications in eyes without adequate capsule support. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.