[Artisan iris claw intraocular lens implantation for the correction of aphakia after pars plana vitrectomy].

OBJECTIVE

To compare the efficacy and complications of Artisan iris claw intraocular lens implantation with those of posterior chamber intraocular lens implantation with ciliary sulcus suture fixation for correction of aphakia in vitrectomized eyes without capsular support.

METHODS

This was a prospective interventional case series. From Jan 2009 to Feb 2012, 53 aphakic vitrectomized eyes without sufficient capsular support were divided into two groups according to the condition of residual capsule. Group one:28 eyes received Artisan iris claw intraocular lens implantation. Group two: 25 eyes received posterior chamber intraocular lens implantation with ciliary sulcus suture fixation. The best corrected visual acuity and intraocular pressure, corneal endothelial cell loss rate, duration of surgery and complications were compared between two groups. Two-independent t-test,Mann-Whitney test and χ² test were used to analyze measurement data of normal distribution, non-normal distribution and count data respectively.

RESULTS

The mean duration of surgery in group one [(11.23 ± 1.54) min] was much shorter (t = -26.60, P < 0.05) than that in group two [(31.68 ± 3.15) min]. The endothelial cell loss rate of group one were (4.39 ± 1.85)%, (4.76 ± 2.06)% and (6.30 ± 2.71)% at 3 months, 6 months and 1 year after surgery, and the data of group two were (3.92 ± 1.85)%, (4.33 ± 1.80)% and (5.73 ± 2.12)% . No statistically significant difference was noted between two groups at any time point (t = 0.77,0.66, 0.69; P > 0.05). The best corrected visual acuity of group one (0.40, 0.12-0.80) was better than that of group two (0.30, 0.08-0.60) at 1 day after surgery(t = -2.16, P < 0.05).However, there was no statistically significant difference at 1 month and 3 months after surgery (P > 0.05). The intraocular pressure of group two [ (11.63 ± 2.29) mmHg, 1 mmHg = 0.133 kPa] was much lower (t = 2.34, P < 0.05) than that of group one [(13.61 ± 3.37) mmHg] at 1 day after surgery. There was no statistical significant difference at 1 month and 3 months after surgery between two groups(P > 0.05). The postoperative complications of group one were anterior uveitis, iris depigmentation, pupillary distortion and spontaneous lens dislocation. Those of group two were choroidal detachment, intraocular haemorrhage, intraocular lens decentration and retinal detachment.

CONCLUSIONS

Iris claw intraocular lens implantation is a simple, fast, less complications and minimally invasive method for the correction of aphakic eyes after vitrectomy. There were on difference in stability and safety between these two implantation methods. Due to the difference of indication choice, either of them can be a viable complement for the other.