Retropupillary iris claw intraocular lens for aphakia.

BACKGROUND

To assess outcomes of the iris claw intraocular lens implanted in the retropupillary position for correction of aphakia without adequate capsular support.

DESIGN

Retrospective study of patients consulted at two private practices and a tertiary public hospital clinic in Brisbane, Queensland.

SAMPLES: Thirty-two consecutive patients who underwent posterior chamber insertion of the iris claw intraocular lens alone or in combination with other procedure/s by the same consultant ophthalmologist (GL).

METHODS

Lens power was calculated using an A-constant of 117.0.

MAIN OUTCOME MEASURES: Clinical examination.

RESULTS

Thirty-four eyes in 32 patients (23 male, 9 female) were included in the study. Indications for surgery were pseudophakic bullous keratopathy (n = 14), aphakia from previous lens extraction/lensectomy (n = 9), subluxation of intraocular lens (n = 7), cataract extraction (n = 2), explantation of anterior chamber intraocular lens due to uveitis (n = 1) and for Baerveldt tube insertion (n = 1). Follow-up duration ranged from 1 to 68 months. Of the 26 eyes followed for at least 6 months, the final vision improved in 69% (n = 18), remained unchanged in 8% (n = 2) and worsened in 23% (n = 6). Final visual acuity was 6/12 or better in 58% (n = 15). Complications included iris trauma/defect (n = 8), pupil irregularity/ovalization (n = 6), microhyphaema (n = 2) and lens decentration (n = 2).

CONCLUSION

Implantation of the iris claw intraocular lens in the retropupillary position is a useful technique for correction of aphakic eyes with sufficient iris support, avoiding the corneal complications of an anterior chamber intraocular lens and the surgical challenge of a sutured posterior chamber intraocular lens.