To Study The Clinical Outcomes Of Retro-Pupillary Iris Claw Iol Fixation In The Pediatric Age Group.

To study the clinical outcomes of retro-pupillary iris claw IOL fixation in the pediatric age group.

Dr.Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India

We conducted an ambispective study where we took 50 eyes of children of the ages (5-15years) with subluxated lens or aphakia with insufficient capsular support who underwent retro-pupillary iris claw IOL fixation from Jan 2019 till August 2020(retrospective arm)and from Aug 2020 till Aug 2021(prospective arm) at our centre and recorded their clinical outcomes in terms of visual acuity, pupil size,central macular thickness, effective lens position on UBM and complications,if any.

With a mean follow-up period of 15months and a mean age of 8.32(±1.52) , the best corrected visual acuity improved from 0.82(±0.45) to 0.30(±0.24)logMAR on our last follow-up.The mean post-up spherical equivalent was +1.12(±1.91) Dioptre sphere at our last follow-up. The endothelial cell count dropped by 2.8%. The maximum pupil dilation wasn’t affected. About 44% eyes had early horizontal pupil ovalisation, 14% had corneal edema on post-operative day one, five had IOL disenclavation, but all were successfully re-enclaved.2% of the eyes had wound leak and subsequent Choroidal detachment on post-op day one which required resuturing. One eye developed retinal detachment on 18 months follow-up. None of the eyes developed Uveitis or glaucoma.

From our study we conclude that retro-pupillary iris claw IOL fixation is a safe method of correcting pediatric aphakia with insufficient capsular support which yields good clinical outcomes.