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Comparative analysis of retropupillary iris claw vs scleral fixated intraocular lens in the management of post cataract aphakia

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Session Details

Session Title: Pseudophakic IOLs: Monofocal

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 16:45

Venue: Room 2.1

First Author: : N.Madhivanan INDIA

Co Author(s): :    P. Nivean   S. Sengupta   M. Sindal   J. Soundarapandian   A. Sheik   M. Arunkumar     

Abstract Details


To compare the visual outcomes and complications between eyes receiving retropupillary iris claw intraocular lens (IOL) and scleral fixated IOL (SFIOL) for post – cataract aphakia.


M N Eye Hospital , Tertiary Eye Hospital ,Chennai , India Aravind Eye Hospital , Tertiary eye Hospital Pondichery , India


Medical records of consecutive patients who had iris claw IOL and scleral-fixated IOL surgery from January 2010 and March 2015, with more than 1 year of follow-up were retrospectively analyzed. The surgical technique was based on individual surgeon preference. The best – corrected distance visual acuity (BCDVA), previous surgery, surgical technique, and complications were analyzed.


Iris Claw IOL was fixated in 48 eyes (46%) and SFIOL performed in the remaining 56 eyes. Iris claw was performed more frequently during primary cataract surgery (56%) compared to SFIOL (14%) (p<0.001). At 1 month postop, BCDVA was significantly better in the SFIOL group (0.3+0.2 logarithm of minimum angle of resolution (logMAR) vs. 0.7+0.5 logMAR, p<0.001) but this difference did not persist at 1 year (0.4+0.4 logMAR in Iris claw vs. 0.3+0.2 logMAR in SFIOL, p=0.56. Eyes with iris claw IOL experienced significantly more postoperative iritis (17%), intraocular pressure spikes (10%) and ovalization of the pupil (16%).


Retropupillary iris claw IOL fixation is as safe as SFIOL for visual rehabilitation of post – cataract aphakia. Visual rehabilitation following iris claw IOL might take longer than SFIOL. Ovalization of the pupil is the commonest adverse effect reported with this type of IOL design.

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