The use of iris claw intraocular lens in aphakic eyes with inadequate capsular support and in phakic eyes for correction of high refractive errors

Abstract

Background Iris-claw intraocular lens (IOL) implantation is effective for correction of aphakia in the absence of capsular support. Iris claw phakic IOLs lack potential size-related complications that may occur with other phakic IOLs.Objective The aim of this study was to evaluate the technique, efficacy, and safety of iris claw IOL implantation.Patients and methods Patients with inadequate capsular support underwent aphakic iris-claw IOL implantation using two techniques: anterior chamber and retro-pupillary fixation of iris-claw lens. Phakic iris claw IOLs were implanted for myopic patients with high refractive errors or with thin or suspicious corneas. Eyes were evaluated for uncorrected and corrected distance visual acuity, refraction, intraocular pressure, and any postoperative complications.Results The study included 17 eyes. Group I included 12 eyes that underwent aphakic iris-claw lens implantation. Indications for surgery were surgical aphakia (n=8), lens dislocation (n=1), and lens subluxation (n=3). Eight eyes had pre-pupillary lens implantation and four eyes underwent retro-pupillary implantation. Group II included five eyes that underwent phakic iris-claw lens implantation. The final postoperative unaided visual acuity was 0.13±0.067 in group I and 0.22±0.076 in group, II, whereas the corrected visual acuity was 0.28±0.193 in group I and 0.34±0.114 in group II. The visual acuity improved significantly compared with the preoperative values (P=0.003 and 0.003, respectively, in group I and P=0.041 and 0.042, respectively, in group II). Postoperative complications included corneal edema, intraocular pressure elevation, inflammatory reaction, pupil ovalization, vitreous hemorrhage, and lens disenclavation.Conclusion Aphakic iris-claw IOL implantation is an effective option for visual rehabilitation in eyes with inadequate capsular support. Phakic iris-claw lens implantation is useful for correction of high refractive errors with high efficacy and safety.