Posterior Iris Fixation of the Iris-Claw Intraocular Lens Implantation through a Scleral Tunnel Incision

Department of Ophthalmology, Uludag University, Boursa, Bursa, Turkey
American Journal of Ophthalmology (Impact Factor: 3.87). 11/2007; 144(4):586-91. DOI: 10.1016/j.ajo.2007.06.009
Source: PubMed


To evaluate the technique, efficacy, and safety of posterior iris fixation of iris-claw intraocular lens (IOLs) implantation through a scleral tunnel incision for aphakia correction.
Noncomparative, interventional case series.
A secondary posterior iris fixation of the Artisan iris-claw IOL (Ophthec BV, Groningen, The Netherlands) was implanted for aphakia correction in the authors' clinical practice. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), astigmatism, manifest refraction, lens position, pigment dispersion, and intraocular pressure (IOP) were evaluated in 32 consecutive eyes of 32 patients.
BSCVA was 20/40 or better in 28 eyes (87.50%) during the mean follow-up time (nine months). Mean postoperative spherical equivalent was -0.70 diopters (D; standard deviation [SD], 0.47 D) at six months after surgery. Mean prediction error was -0.13 D (SD, 0.28 D), and mean absolute prediction error was 0.26 D (SD, 0.15 D). Preoperative mean astigmatism was -1.08 D (SD, 0.55 D; range, 0.0 to -2.0 D). At six months after surgery, mean astigmatism was -2.1 D (SD, 0.81 D; range, -0.75 to -3.75 D). There was no significant postoperative IOP increase. Lens position, evaluated by Oculus Pentacam (Pentacam 70700: Oculus, Wetzlar, Germany) and ultrasound biomicroscopy [UBM] (Ophthalmic Technologies Inc, Toronto, Ontario, Canada), was parallel to the iris plane.
Posterior iris fixation of the iris-claw IOL implantation through a scleral tunnel incision is a safe procedure and an effective option for aphakic eyes without capsule support.

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    • "If we consider only the patients without preoperative comorbidity, the BCVA improved in 13 of 17 patients (76%). Overall, this result agrees with the results from other studies.7,16,17 Peaked pupils were seen postoperatively in ten patients but none showed a pigment dispersion. "
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    ABSTRACT: To evaluate the technique, safety, and efficacy of the retropupillary implantation of iris-claw intraocular lenses in a long-term follow-up study. This retrospective study included 31 eyes of 31 patients who underwent an Artisan aphakic intraocular lens implantation between January 2006 and February 2011 at the University Hospital Essen, Essen, Germany and at the Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, Germany. Preoperative data collected included demographics, etiology of aphakia, previous surgeries, preoperative eye pathology, intraocular pressure, clinical signs of endothelial cell loss, and best corrected visual acuity. Operative data and postoperative outcomes included the best corrected visual acuity, lens position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, development of macular edema, and other complications. Thirty-one patients were included. The mean follow-up was 25.2 months (range: 4-48 months). The mean best corrected visual acuity postoperatively was 0.64 logarithm of the minimum angle of resolution (logMAR) and varied from 0 logMAR to 3 logMAR. Some patients had a low visual acuity preoperatively because of preoperative eye pathologies. In 22 patients the visual acuity improved, in two patients the visual acuity remained unchanged, and seven patients showed a decreased visual acuity. Complications were peaked pupils (n=10) and retinal detachment in one case. Four patients showed an iris atrophy and high intraocular pressure was observed only in one patient. Subluxation of the intraocular lens, endothelial cell loss, and macular edema were not observed. The presented long-term results demonstrate that retropupillary iris-claw lens implantation is a safe and effective method for the correction of aphakia in patients without capsule support. This surgical procedure has the advantages of a posterior chamber implantation with a low intraoperative and postoperative risk profile.
    Clinical ophthalmology (Auckland, N.Z.) 01/2014; 8:137-41. DOI:10.2147/OPTH.S55205
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    • "No major complication was observed and the new technique was shown to be superior (in terms of simplicity, reliability, and anatomical results) to other techniques. Another study also confirmed the relative safety of posterior iris fixation of the iris-claw IOL through a scleral tunnel incision in patients without adequate capsular support.27 "
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    ABSTRACT: We report a combination of surgical techniques during Descemet-stripping automated endoithelial keratoplasty and intraocular lens (IOL) exchange in patients with pseudophakic bullous keratopathy and angle-supported anterior chamber IOLs. During this procedure, the anterior chamber IOL is exchanged for a posterior chamber iris-claw IOL enclavated to the posterior iris; the anterior chamber is kept filled with air using an air-fluid exchange machine during descemetorhexis and insertion of the donor endothelial disk.
    Journal of Cataract and Refractive Surgery 02/2011; 37(2):224-8. DOI:10.1016/j.jcrs.2010.11.021 · 2.72 Impact Factor
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    ABSTRACT: To describe a new scleral fixation foldable intraocular lens (IOL): the Ultima. The novel IOL is a new scleral fixation acrylic hydrophilic foldable lens that offers a 360 degrees sulcus support due to its round geometry. It can be folded and inserted through a 4 mm clear cornea incision. Twenty-five eyes implanted with the Ultima lens were followed for 2 years. Twenty-two eyes showed visual improvement, two eyes had no functional improvement, and one eye had visual deterioration. The IOL remained well centered and showed no signs of tilting in all patients during the entire follow-up. The main advantages of the Ultima IOL include the lack of tilting and the minimum postoperative astigmatism. It also allows a clear retinal examination and provides an excellent barrier for silicone oil between vitreous cavity and anterior chamber.
    European journal of ophthalmology 01/2008; 18(6):895-902. · 1.07 Impact Factor
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