Secondary Iol Implantation In The Absence Of Capsular Support: Scleral-Fixated Vs Iris-Claw Iols

Cataract surgery via phacoemulsification with intraocular lens (IOL) placement in the capsular bag is the gold standard in the presence of adequate capsular support. However, when capsule and/or zonular fibers are weak or absent, alternate fixation strategies are required. Common alternative options include retropupillary iris-claw IOLs (RP- ICIOLs) and scleral-fixated IOLs (SFIOLs).

Department of Ophthalmology, San Marino State Hospital, Republic of San Marino

In the present review of 87 articles with 2174 eyes implanted with RP-ICIOLs and 2980 eyes with SFIOLs, we discuss the published literature of SFIOLs and RP-ICIOLs with respect to safety and efficacy.

Although the studies reporting outcomes of these IOLs have been performed in patients with different concomitant conditions, visual and refractive outcomes were found to be comparable between RP-ICIOLs and SFIOLs.

RP-ICIOL implantation seemed to provide equivalent or potentially lower rate of complications than SFIOL implantation. Data from the literature also suggest that the surgical technique of RP-ICIOL implantation is relatively simpler with correspondingly shorter surgical time.