Iris claw lens for surgical correction of aphakia-long term (5 year) results
Journal Title: Medpulse International Journal of Ophthalmology - Year 2017, Vol 1, Issue 2
Abstract
Purpose: To evaluate the long term stability, safety and efficacy of retropupillary posterior iris fixation of iris claw lens in cases without adequate capsular support for placement of a posterior chamber (PC) intraocular lens (IOL) in the capsular bag or in the sulcus. Method: 100 aphakic eyes of 100 patients with no capsular support underwent retropupillary posterior iris fixation of iris claw intraocular lens (Excel Optics, Chennai, Model No.PIC 5590). Two cases had undergone Vitreoretinal (VR) surgery for traumatic lens dislocation. Rest were post cataract surgery cases. Of these four cases had undergone VR surgery for nucleus drop and two for IOL drop. All the cases underwent secondary IOL implantation. Postoperative best corrected visual acuity (BCVA), intraocular pressure, tissue reaction, pigment dispersion and stability of IOL were studied at 1month, 3months, one year, two year ,three year, four year& five years. Results: Postoperatively all cases achieved BCVA equal to or better than preoperative BCVA. More than 90% of the cases achieved postoperative visual acuity of 6/18 or better. Two IOLs developed early disenclavation and were successfully reenclavated without any complication. All the other IOLs were stable. Two of the post VR surgery cases developed retinal detachment between third and fourth years.There was no significant postoperative inflammatory reaction or surgically induced glaucoma in any of the cases. Three cases were lost to follow up by four years and another two by five years. In all the 95 cases that could be followed up for 5 years the retropupillary posterior iris fixated intraocular lenses remained stable and well centred. Conclusion: Retropupillary posterior iris fixation of iris claw IOL is a safe and effective procedure for eyes without adequate capsular support for placement of a posterior chamber intraocular lens in the capsular bag or sulcus. Post Vitreoretinal surgery cases should be followed up more frequently and more carefully.
Authors and Affiliations
Sreeni Edakhlon, Gopal S Pillai
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