Visual outcomes and complications of posterior iris-claw intraocular lens implantation in aphakic postvitrectomized eyes

Abstract

Purpose: To evaluate refractive outcome, anatomical outcome, complications of posterior chamber iris-claw aphakic intraocular lens (IOL) implantation after pars plana vitrectomy. Methods: A retrospective analysis of consecutive 25 eyes of 25 pts (12 males & 13 females) without capsular support in which we performed posterior chamber iris-claw implantation after pars plana vitrectomy. Retro-pupillary iris claw lens were either implanted in the same procedure along with vitrectomy (15 eyes, Group A) or later in different procedure (10 eyes, Group B) in post vitrectomised eyes. Posterior vitrectomy procedures were performed with 23- or 25-gauge techniques for different associated anterior or posterior segment indications. Visual outcomes, anatomical outcome, stability of the implants, and complications were analysed. Results: The mean patient age was 62.3 years(range, 21–78 years) in group A; 60.1 years (range, 19-80 years) in group B. The mean follow-up time was 4.12 months (range, 1-12 months). In Group A 6 eyes had lens dislocation aphakia (5 traumatic, 1 surgical) & 7 IOL dislocation aphakia (3traumatic, 4 surgical). In Group B 5 eyes had lens dislocation aphakia(4 traumatic,1 surgical) and 2 IOL dislocation aphakia(1 traumatic,1 surgical). At the end of the follow up the mean post-operative best-corrected LogMAR visual acuity was 0.244±0.25 in group A; 0.286±042 in group B which was statistically significant as compared preoperatively. Intergroup best corrected visual acuity comparisons at the end of follow up were not statistically significant. Similarly within group spherical equivalent decreased statistically when compared to the preoperative values. Between group comparisons, spherical equivalent values were not significant. Intra-op anterior chamber collapse was not seen in any case. Disenclavation of iris claw lens was not seen in any case. No corneal edema was observed. 1 case of uveitis was observed. 1 case of post-op macular edema was observed. 3 cases had increased post-op intraocular pressure.1 case had post-op vitreous hemorrhage which resolved spontaneously, retina attached in all cases. Conclusion: In summary posterior chamber iris-claw IOL implantation in aphakic eyes without capsular support in post vitrectomized is an effective, predictable and safe procedure.