Management of traumatic dislocation of crystalline lens: Retropupillary iris-claw versus sutureless intrascleral-fixated intraocular lens.

Abstract

PURPOSE:The purpose of this study was to compare the long-term efficacy and safety of posterior iris-claw lens and scleral-fixated posterior chamber lens for aphakia after traumatic posterior dislocation of the crystalline lens.MATERIAL AND METHODS:Out of 120 evaluated cases, 60 were randomly assigned in each group. A 23G vitrectomy was done and intraocular lens was implanted by two different techniques. Extensive preoperative and postoperative evaluation was performed including optical coherence tomography and Scheimpflug imaging. Follow-up was done on days 1, 7, and 28 at 3 months, 6 months, and 12 months.RESULTS:A significant improvement was found in uncorrected visual acuity in both the groups. Surgical time in iris fixation was significantly less (P < 0.001), whereas pupil peaking and pigment release were more. Difference in mean intraocular pressure and change in astigmatism in both the groups were insignificant.CONCLUSION:Both the techniques had similar good visual results. Although operating time was shorter for iris fixation, it had several disadvantages, including immediate postoperative inflammation and ovalling of the pupil. However, scleral fixation had a better outcome in terms of postoperative complications.