Abstract
Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2). The mean preoperative CDVA was 0.25 (SD 0.21). The final mean CDVA was 0.46 (SD 0.27). No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was −0.27 Dsph (−3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28). The mean postoperative astigmatism was −1.82 Dcyl (min −0.25, max −5.5; median −1.25, SD 1.07). Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4). Conclusion. Retropupilary iris-claw intraocular lens (IOL) implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction.
Highlights
The development of intraocular surgical technique of refraction correction in aphakic eyes has been observed recently
Aphakia is commonly the result of complications arising from cataract surgery
Retropupillary localization, due to increased distance from corneal endothelium and angle structures, has protective significance for endothelium and intraocular pressure (IOP) rise, which is especially important for PEX and glaucoma patients
Summary
The development of intraocular surgical technique of refraction correction in aphakic eyes has been observed recently. Aphakia is commonly the result of complications arising from cataract surgery. The most common risk factors of intraoperative complication are weakness of zonular fibers mostly due to PEX or trauma. Despite a lack of capsular support or its insufficiency, when the implantation of intraocular lens (IOL) into the ciliary sulcus is unmanageable, it is still possible to achieve satisfactory refraction. There are many possibilities to provide acceptable refraction in such eyes by implanting IOL in the anterior or posterior segment of the eye during primary or secondary operation, which is still debatable. The location of the implantation and its method of fixation determine complexity of the surgery and potential side effects
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