VISUAL OUTCOMES AND COMPLICATIONS OF IRIS-CLAW INTRAOCULAR LENS IMPLANTATION IN APHAKIC EYES WITH INADEQUATE CAPSULAR SUPPORT
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Keywords:
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aphakia, iris claw, intraocular lens
Abstract
Introduction: Aphakia with inadequate capsular support remains a challenge for ophthalmologist. Although there is no consensus on the best method for this case, many studies have been reported using iris claw intraocular lens for secondary implantation.
Objective: To evaluate the various indications, visual outcomes, and complications of iris claw intraocular lens in aphakic eyes.
Methods : This retrospective case study was conducted in Undaan Eye Hospital, Surabaya, collecting data from medical records with a total of 188 eyes of 186 patients between May 2017 and April 2020, that were rehabilitated with prepupillary and retropupillary fixation of an iris claw lens. Patients were followed-up to 9 months for visual acuity and complications.
Results: The most common cause of aphakia was subluxation of lens (spontaneous, trauma or congenital) in 90 of the 188 eyes (47.3%). The mean follow-up was 3 months (range :1-9 month). Most patient had the best preoperative BCVA (0-0.50 logMAR) 63%, ranging 0-2.47 logMAR with a mean of 0.72 logMAR. At final follow up, of the total patients, 72.9 % had the BCVA of 0-0.5 logMAR, with a mean of 0.37 logMAR. Complication included secondary glaucoma 2.12%, uveitis 1.06 %, iridodyalisis 1.06 %, and bullous keratopathy 1.06%.
Conclusion: iris claw IOL implantation is a safe and effective method of rehabilitating aphakic eye with inadequate capsular support.
References
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5. Forlini M, Soliman W, Bratu A, Rossini P, Cavallini GM, Forlini C. Long-term follow-up of retropupillary iris-claw intraocular lens implantation: a retrospective analysis. BMC Ophthalmol. 2015 Dec;15(1):143. https://pubmed.ncbi.nlm.nih.gov/26507387/
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Ophthalmol Ina 2023;Vol. 49(1):3-9
7. Jing W, Guanlu L, Qianyin Z, Shuyi L, Fengying H, Jian L, et al. Iris-Claw Intraocular Lens and Scleral- Fixated Posterior Chamber Intraocular Lens Implantations in Correcting Aphakia: A Meta-Analysis. Investig Opthalmology Vis Sci. 2017 Jul 14;58(9):3530. https://pubmed.ncbi.nlm.nih.gov/28715586/
8. Schallenberg M, Dekowski D, Hahn A, Laube T, Steuhl K-P, Meller D. Aphakia correction with retropupillary fixated iris-claw lens (Artisan) – long-term results. Clin Ophthalmol. 2013 Dec;137. https://pubmed.ncbi.nlm.nih.gov/24391439/
9. Toro MD, Longo A, Avitabile T, Nowomiejska K, Gagliano C, Tripodi S, et al. Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation. Achiron A, editor. PLOS ONE. 2019 Apr 10;14(4):e0214140. https://pubmed.ncbi.nlm.nih.gov/30970023/
10. Vounotrypidis E, Schuster I, Mackert MJ, Kook D, Priglinger S, Wolf A. Secondary intraocular lens implantation: a large retrospective analysis. Graefes Arch Clin Exp Ophthalmol. 2019 Jan;257(1):125–34. https://pubmed.ncbi.nlm.nih.gov/30413876/
11. AnandhiD,SravyaMr.Clinicaloutcomeofiris-clawintraocularlensimplantation.TNOAJOphthalmicSci Res.2019;57(1):3.https://www.tnoajosr.com/article.asp?issn=25894528;year=2019;volume=57;issue=1;spa ge=3;epage=7;aulast=Anandhi
12. De Silva SR, Arun K, Anandan M, Glover N, Patel CK, Rosen P. Iris-claw intraocular lenses to correct aphakia in the absence of capsule support: J Cataract Refract Surg. 2011 Sep;37(9):1667–72. https://pubmed.ncbi.nlm.nih.gov/21855764/
13. Jayamadhury G, Potti S, Kumar Kv, Kumar Rm, Divyansh Mishra K, Nambula S. Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes. Indian J Ophthalmol. 2016;64(10):743. https://journals.lww.com/ijo/fulltext/2016/64100/retropupillary_fixation_of_iris_claw_lens_in.9.aspx
2. Hazar L, Kara N, Bozkurt E, Ozgurhan EB, Demirok A. Intraocular Lens Implantation Procedures in Aphakic Eyes With Insufficient Capsular Support Associated With Previous Cataract Surgery. J Refract Surg. 2013 Oct 1;29(10):685–91. https://pubmed.ncbi.nlm.nih.gov/23898947/
3. El-Saadany A-KI, Khairy HA, Rajab GZ, Fayed AMS. The use of iris claw intraocular lens in aphakic eyes with inadequate capsular support and in phakic eyes for correction of high refractive errors. :10. https://www.djo.eg.net/article.asp?issn=11109173;year=2020;volume=21;issue=1;spage=25;epage=34;aula st=El-Saadany
4. Periyanayagi M, Selvaraj N, Sivakami M. Posterior iris-claw intraocular lens implantation as an effective
option in aphakia. TNOA J Ophthalmic Sci Res. 2017;55(4):282. https://www.tnoajosr.com/article.asp?issn=2589- 4528;year=2017;volume=55;issue=4;spage=282;epage=285;aulast=Periyanayagi
5. Forlini M, Soliman W, Bratu A, Rossini P, Cavallini GM, Forlini C. Long-term follow-up of retropupillary iris-claw intraocular lens implantation: a retrospective analysis. BMC Ophthalmol. 2015 Dec;15(1):143. https://pubmed.ncbi.nlm.nih.gov/26507387/
6. Faria M, Pinto Ferreira N, Medeiros Pinto J, Cordeiro-Sousa D, Cardoso-Leal I, Neto E, et al. Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens. Int Med Case Rep J. 2016 Aug;Volume 9:261–5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010170/
Ophthalmol Ina 2023;Vol. 49(1):3-9
7. Jing W, Guanlu L, Qianyin Z, Shuyi L, Fengying H, Jian L, et al. Iris-Claw Intraocular Lens and Scleral- Fixated Posterior Chamber Intraocular Lens Implantations in Correcting Aphakia: A Meta-Analysis. Investig Opthalmology Vis Sci. 2017 Jul 14;58(9):3530. https://pubmed.ncbi.nlm.nih.gov/28715586/
8. Schallenberg M, Dekowski D, Hahn A, Laube T, Steuhl K-P, Meller D. Aphakia correction with retropupillary fixated iris-claw lens (Artisan) – long-term results. Clin Ophthalmol. 2013 Dec;137. https://pubmed.ncbi.nlm.nih.gov/24391439/
9. Toro MD, Longo A, Avitabile T, Nowomiejska K, Gagliano C, Tripodi S, et al. Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation. Achiron A, editor. PLOS ONE. 2019 Apr 10;14(4):e0214140. https://pubmed.ncbi.nlm.nih.gov/30970023/
10. Vounotrypidis E, Schuster I, Mackert MJ, Kook D, Priglinger S, Wolf A. Secondary intraocular lens implantation: a large retrospective analysis. Graefes Arch Clin Exp Ophthalmol. 2019 Jan;257(1):125–34. https://pubmed.ncbi.nlm.nih.gov/30413876/
11. AnandhiD,SravyaMr.Clinicaloutcomeofiris-clawintraocularlensimplantation.TNOAJOphthalmicSci Res.2019;57(1):3.https://www.tnoajosr.com/article.asp?issn=25894528;year=2019;volume=57;issue=1;spa ge=3;epage=7;aulast=Anandhi
12. De Silva SR, Arun K, Anandan M, Glover N, Patel CK, Rosen P. Iris-claw intraocular lenses to correct aphakia in the absence of capsule support: J Cataract Refract Surg. 2011 Sep;37(9):1667–72. https://pubmed.ncbi.nlm.nih.gov/21855764/
13. Jayamadhury G, Potti S, Kumar Kv, Kumar Rm, Divyansh Mishra K, Nambula S. Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes. Indian J Ophthalmol. 2016;64(10):743. https://journals.lww.com/ijo/fulltext/2016/64100/retropupillary_fixation_of_iris_claw_lens_in.9.aspx
Authors
Fauzi, F. N., Dharmawidiarini, D. ., Moenir, F. ., & Napitupulu, S. P. . (2023). VISUAL OUTCOMES AND COMPLICATIONS OF IRIS-CLAW INTRAOCULAR LENS IMPLANTATION IN APHAKIC EYES WITH INADEQUATE CAPSULAR SUPPORT. Ophthalmologica Indonesiana, 49(1), 3–9. https://doi.org/10.35749/journal.v49i1.100592
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