Abstract
Purpose: To assess the indications and visual outcome of eyes undergoing posterior iris fixated intraocular lens (IFIOL) implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications.
 Methods: In this retrospective case series study, all cases of posterior IFIOL fixation performed over a 30-month period were identified retrospectively. Preoperative and postoperative evaluations comprised objective and subjective refraction, best corrected visual acuity (BCVA), slit lamp biomicroscopy, applanation tonometry, and dilated fundus examination.
 Results: Fifty-six eyes of 56 patients were analyzed. Mean age was 60.55 ± 17.2 years. The most common indication for IFIOL implantation was surgical aphakia following complicated cataract surgery (n = 33; 58.9%) followed by trauma (n = 10; 17.9%), dropped nucleus/IOL during primary surgery (n = 6; 10.7%), and subluxated/dislocated lens-induced glaucomas (n = 5; 8.9%). BCVA better than or equal to their preoperative BCVA was achieved in 96.43% patients. The surgical aphakia and paediatric/adolescent groups had the best visual results while the dropped nucleus/IOL group and subluxated lens-induced glaucoma groups fared poorly. On the long-term follow-up visit, the most common complication noted was pigment dusting on the corneal endothelium (65.7%).
 Conclusion: The long-term results suggest that posterior IFIOL implantation is a safe and effective method for correction of aphakia and can be used for a wide range of indications in eyes without adequate capsule support. It may be considered an easier and faster alternative with minimal manipulation to anterior segment structures in paediatric and post-traumatic aphakic eyes.
Highlights
In aphakic eyes without adequate capsular support for intracapsular or posterior chamber sulcus placement of intraocular lens (IOL), alternative methods of IOL fixation are to be considered
The data of 56 patients were retrieved from the medical records department of our eye hospital and analysed for 56 eyes that underwent iris fixated intraocular lens (IFIOL)
IFIOL was implanted most commoly in surgical aphakia following complicated cataract surgery (n = 33; 58.9%)
Summary
In aphakic eyes without adequate capsular support for intracapsular or posterior chamber sulcus placement of intraocular lens (IOL), alternative methods of IOL fixation are to be considered. This presents a debate between selection of anterior. Retro-fixated iris claw lens circumvents the aforesaid problems. The implantation of the IFIOL behind the iris better preserves the anatomy of the anterior segment with respect to the iridocorneal angle. As there are only few works related to iris claw reported earlier, this work is planned to assess the indications and visual outcome of eyes undergoing IFIOL implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications
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