ABSTRACT

To evaluate the visual outcomes and complications of iris-claw intraocular lenses (ICIOL) implanted in cases of aphakia or in cataract surgery with insufficient capsule support.

In this retrospective study, we reviewed the medical records of 34 eyes of 34 patients who had undergone ICIOL implantation with a minimum follow-up of 12 months in Bucak State Hospital and in a private hospital between November 2007 and November 2012.

Twenty-one eyes with complicated cataract accompanied by zonular deficiency, 8 eyes with aphakia, and 5 eyes with dislocated IOL were operated and ICIOL implanted. Mean preoperative BCVA was 1.46±1.05 LogMAR and postoperative BCVA was 0.20±0.21 LogMAR. There was an improvement in visual acuity in 31 eyes of the 34 patients, and 29 of them had a visual acuity better than 6/12 postoperatively. Mean postoperative spherical equivalent (SE) was -0.76±0.94 D, and deviation from estimated SE was -0.26±0.94 D. Mean preoperative astigmatism was -1.36±0.77 Cyl D and mean postoperative astigmatism was -0.98±0.82 Cyl D. In second postoperative month, one case had a pupillary block glaucoma due to the closure of peripheral iridotomy, and after ND-YAG laser treatment, intraocular pressure return to normal value. One eye had iris pigment precipitates on the ICIOL in early postoperative period, and in one case, there was a pupillary ovalization. Three months after a cataract surgery, retinal detachment developed in one eye of a patient who had a history of severe ocular trauma; anterior vitrectomy and ICIOL implantation were performed. Visual acuity remained unchanged after a successful pars plana vitrectomy operation.

Iris-claw lenses provide fairly good visual outcomes in aphakic eyes without capsular support and in challenging cataract cases with zonular deficiency. They are safe regarding complications when compared to other alternative intraocular lens implantation methods.