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Outcomes and complications of retropupillary iris claw intraocular lens implants

Poster Details

First Author: P.Antonopoulou UK

Co Author(s):    F. Dhawahir-Scala   A. Jalil   T. Ivanova   D. Park     

Abstract Details

Purpose:

Retropupillary iris claw lens implantation has been recently introduced for the surgical correction of aphakia in cases with insufficient capsular support. The main advantages of this procedure is the insertion of the lens closer to its anatomical position, away from the endothelium, and the simplicity of the surgical technique. The aim of the study was to assess the post-operative outcomes and complications of posterior chamber iris claw lens implantation in cases where endocapsular placement is not possible.

Setting:

In this study we included all cases of retropupillary Artizan iris claw lens implantation operated by a single surgeon at the Manchester Royal Eye Hospital, UK between 2011 and 2015.

Methods:

The case notes of all 17 patients (18 eyes) who underwent enclavation of Artisan lenses at the posterior surface of the iris were retrospectively reviewed. The mean age of patients was 67 years. Indications for surgery were aphakia from previous complicated cataract extraction (61% of the cases), intraocular lens implant sublaxation (28%), and dislocation of the natural lens (11%). All patients were followed up for a minimum period of 6 months. Data were collected regarding the final best corrected visual acuity (BCVA), refractive outcome and postoperative complications.

Results:

Final vision improved in 89% (n = 16) and worsened in 11% (n = 2) of cases. The post-operative BCVA was better than 6/7.5 in 39% and between 6/9 and 6/15 in 22% of cases. The spherical equivalent was within 1 dioptre of the aimed refractive outcome in 64% of patients. 33% of patients required short term treatment for intraocular pressure spikes and 33% for macular oedema at any time during the follow up period. There were no cases of endothelial decompensation, endophthalmitis or severe post operatively inflammation. One patient underwent lens repositioning after disenclavation of the implant.

Conclusions:

Implantation of retropupillary iris claw lenses is a relatively simple procedure. Some surgeons consider this technique to be the preferred option in cases of insufficient capsular support. Some others perform it as an alternative in cases where insertion of transsclerally fixated posterior chamber lenses, anterior chamber angle supported lenses or anterior iris claw lenses can be problematic. The results of our study suggest good visual acuity outcomes but the incidence of macular oedema and increased intraocular pressure cause concern. In order to evaluate the safety profile of the posterior Artizan lenses a long-term follow up of the patients is required. FINANCIAL DISCLOUSRE: NONE

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