Iris-claw, retropupillary-fixated, aphakic intraocular lens implantation for traumatic aphakia following penetrating keratoplasty

Purpose: To compare results of sutureless transscleral intraocular lens (IOL) fixation to retropupillary iris-claw lens implantation in cases of paediatric aphakia without capsular support. Methods: Thirty eyes of children with insufficient capsular support for IOL implantation were randomized to undergo sutureless transscleral IOL fixation or iris-claw lens fixation. The primary outcome was best-corrected visual acuity (BCVA). Secondary outcomes included operative time, astigmatism, central corneal thickness, endothelial cell count (ECC), IOL decentration and tilt, central foveal thickness and complications. Results: There was a significant improvement in BCVA at all follow-up visits, with no significant difference between both groups. 53.3% in the transscleral-fixated IOL group and 80% in the iris-claw IOL group had a final BCVA ≥0.3. The operative time was significantly shorter in the iris-claw IOL group (p = 0.001). IOL decentration and tilt were higher in the transscleral-fixated IOL group, but the difference was not significant. The ECC was reduced by 14.6% in the transscleralfixated IOL group and 11% in the iris-claw group at 6 months, with no significant difference between both groups (p = 0.5). In the transscleral-fixated IOL group, two eyes developed ocular hypertension and two eyes had IOL decentration, while in the iris-claw IOL group, 1 eye developed glaucoma, three eyes had haptic disenclavation, and one eye had retinal detachment. Conclusion: Both techniques yielded a comparable visual outcome. Retropupillary iris-claw lens fixation is a shorter procedure and technically easier than sutureless transscleral fixation, but the risk of disenclavation should be considered especially in younger age groups. Scleral fixation is the only option in case of severe iris damage, but may be associated with more endothelial cell loss.

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“…Anglada‐Escalona et al. () reported a 13.6% reduction at 1 year, and Anbari () found an 11.9% reduction at 2 years. Baykara et al.…”

Section: Discussionmentioning

confidence: 97%

Transscleral sutureless intraocular lens versus retropupillary iris‐claw lens fixation for paediatric aphakia without capsular support: a randomized study

Shuaib

Sayed

Kamal

et al. 2019

Acta Ophthalmologica

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Iris-claw, retropupillary-fixated, aphakic intraocular lens implantation for traumatic aphakia following penetrating keratoplasty

Cited by 1 publication

References 17 publications

Transscleral sutureless intraocular lens versus retropupillary iris‐claw lens fixation for paediatric aphakia without capsular support: a randomized study

Transscleral sutureless intraocular lens versus retropupillary iris‐claw lens fixation for paediatric aphakia without capsular support: a randomized study

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