[Retroiridal iris claw lens as routine procedure].

BACKGROUND

Absence of capsular support or extended zonulolysis is today the main indication for retroiridal enclavation of the unfoldable PMMA iris claw lens (Verisyse®/Artisan®) if there is sufficient iris support. Contraindications are uveitis or ischaemic retinopathies.

PATIENTS AND

METHODS

'In-the-bag' IOL dislocation due to PEX zonulopathy usually occurring 8 years after phacoemulsification is the main indication. For complicated phacoemulsification with extended zonular defect the retroiridal iris claw lens (Verisyse®/Artisan®) has become the stand-by IOL of first choice. A rare indication for Verisyse is optical rehabilitation after lens luxation into the vitreous in combination with vitrectomy.

RESULTS

81 eyes were analysed. With laseroptic biometry target refraction was within 1 D for 100 % of the 'in-the-bag' luxation cases and in 62 % for the other more complicated cases. Wavefront analysis showed no significant difference for optical quality between retroiridal iris claw lens and a endocapsular fixated spherical for scotopic 5 mm pupil. Iris pigment atrophies of the enclavation site had no clinical significance. Risk for cystoid macular oedema is lower compared to sclera suture-fixated posterior chamber lenses. Intra- and postoperative complications were rare. Spontaneous or traumatic de-enclavation due to haptic defects may occur. After vitrectomy instable refraction may be caused by hypermobile iris diaphragma.

CONCLUSIONS

Retroiridal iris claw lenses can be implanted atraumatically under topical anaesthesia. IOL related complications are minimal.