Comparative Analysis of Iris Claw Anterior Chamber Fixation Versus Suture less Intrascleral Intraocular Lens Implantation in the Management of Aphakia

Abstract

Purpose: To determine the efficacy of iris claw anterior chamber fixation versus suture less intrascleral intraocular lens implantation in terms of visual recovery and complications during and after surgery. Method: The present prospective observational study was conducted in the Postgraduate Department of Ophthalmology at SMHS Hospital, Govt. Medical College, Srinagar over a period of one and half year. Results: A total of 30 patients were studied and divided equally into two groups with patients age ranging between 19-70 years with mean age of 49.5+17.41 years in iris claw anterior chamber IOL group and in suture less intrascleral fixated IOL group with age ranging between 24-70 years with a mean age of 51.9+15.94 years. Primary fixation of IOL was implanted in 8 (26.7%) patients, out of which 5 (33.3%) underwent iris claw anterior chamber IOL fixation and 3 (20%) patients underwent suture less intrascleral fixated IOL while the remaining 22 (73.3%) underwent secondary IOL.Mean preoperative BCVA improved from log MAR 0.78+0.251 in iris claw anterior chamber IOL to log MAR 0.85±0.241 in suture less intrascleral fixated IOL to log MAR {0.23±0.206 & 0.18±0.191} in two study groups respectively. Eyes with iris claw IOLexperienced pigment precipates (73.3%) followed by ovalisation of pupil (26.7%) while as intraocular pressure (33.3%) followed by corneal edema (13.3%) and transient hypotony (6.7%) were seen in suture less intrascleral fixation of IOL. Conclusion: It was concluded that both irises claw anterior chamber IOL fixation and suture less SFIOL using flange are viable options for surgical correction of aphakia.