Clinical Outcomes And Complications Of Iris-Claw Intraocular Lens Implantation In 160 Eyes In A Tertiary Medical Center: A Retrospective Analysis

To assess the clinical outcomes and complications associated with Artisan iris-claw intraocular lens implantation in 160 eyes at our institution between 2018 and 2024, with particular emphasis on corneal decompensation and macular cystoid edema.

The study was conducted at Cruces University Hospital, a tertiary medical center located in the north of Spain. The hospital serves a diverse population with a broad spectrum of pathology, where we should highlight the high incidence of pseudoexfoliation due to our geographical location. The procedures were performed in a state-of-the-art surgical environment, equipped with modern diagnostic and surgical technologies to ensure the precise implantation of Artisan intraocular lenses.

A retrospective analysis was conducted on 160 eyes that underwent Artisan intraocular lens (IOL) implantation for the correction of cataract and refractive errors between 2018 and 2024. Preoperative and postoperative data, including patient´s visual acuity, lens indications and complications, were collected and analyzed. Within the complications, we emphasized the presence and onset timing of corneal decompensation and macular cystoid edema. We also recorded the intraocular position of the lens, distinguishing between pre-pupillary and retro-pupillary placement.

In our study, the Artisan lens was mainly implanted in patients without an intact capsular bag or required an IOL exchange. The most common indication was the dislocation of a previously implanted capsular IOL (52.5%), probably due to the high incidence of pseudoexfoliation in our region. Other indications included rupture of the capsular bag (31.25%), trauma (3.1%) and crystalline lens dislocation (6.9%). A total of 58.75% of our patients showed an improvement in visual acuity of at least three optotype lines. Complications related to Artisan IOL implantation were observed in 36.3 % of the patients, with macular cystoid edema being the most frequent (19.4%), followed by corneal decompensation (17.5%) and subluxation of the Artisan (3.1%).

Artisan IOL appears to be a reliable option for patients lacking an intact capsular bag or requiring IOL exchange. Complications were observed in a significant proportion of our patients, probably not exclusively related to the lens itself but also influenced by the overall clinical context of these eyes. The most prevalent complications included macular cystoid edema, corneal decompensation, and subluxation of the Artisan lens. Further studies are needed to assess long-term outcomes in these patients and to better correlate the complication with the Artisan lens.