Iris-Sutured Intraocular Lens And Their Long-Term Outcomes

To evaluate the outcomes and complications of iris-sutured intraocular lens (ISIOL). This would be the largest case series of ISIOL thus far, with the longest average follow-up.

Retrospective, consecutive cases of eyes that underwent ISIOL (iris claw IOLs were excluded) over 12 years by a single surgeon or under the supervision of the aforesaid surgeon at a single institute.

Patients’ medical records were reviewed for demographics, clinical risk factors, concomitant ocular conditions, indications for surgery, intra-operative procedures, intra- and post-operative complications, axial length, endothelial cell density, pre and post-operative vision and refractive error.

There were 194 cases with a mean follow-up of 28.1 months. The most common indication for surgery was a subluxed IOL (111 cases, 57.2%). 67 cases had a new IOL implanted, whereas 127 cases had the pre-existing IOL fixated. Post-operatively, there was significant improvement in visual acuity compared to baseline. Mean refractive spherical equivalent was -1.43. Eyes with a newly inserted IOL were significantly less myopic than those using the pre-existing IOL. The most common post-operative complications were intraocular pressure (IOP) spike (26.8%), cystoid macular oedema (CMO) (10.3%), and corneal edema (8.8%). The most common late (>36 months) complications were raised IOP (6.7%), subluxed IOL (3.6%), and corneal edema (1.0%).

Iris-sutured IOL is still a reasonable and safe option, especially for cases with posterior capsule rupture and a partial capsule present, in an older patient. There tends to be a myopic outcome, which is reduced if a new IOL was inserted. Common complications include IOP spikes, CMO, and corneal edema.