Surgical outcomes of retropupillary-fixated iris-claw intraocular lens

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

“…In fact, the postoperative mean IOP was significantly lower than the preoperative IOP at the 1-month follow-up postoperatively and remained stable thereafter. In agreement with our results, previous studies demonstrated that the mean IOP at the time of last follow-up after R-IOL implantation was significantly lower than 19 or similar to the preoperative IOP 16,17 . Furthermore, six of the eight eyes that experienced IOP elevation required just a week of treatment with IOP lowering agents, indicating that the IOP elevation may be due to post-vitrectomy inflammation rather than the R-IOL itself.…”

“…Previously reported disenclavation rates of R-IOL have varied between studies. Similar to our results, a 6.6% disenclavation rate of 122 eyes was reported over 7.5 months 17 , whereas Gonnermann et al reported a higher disenclavation rate (14% of 137 R-IOL eyes) over 6.7 months 19 . In other studies of R-IOL eyes, disenclavation has been observed at a lower rate; for example, one reported disenclavation in 3/320 (0.9%) eyes 12 and another reported 2/93 (2.1%) eyes being affected 14 during a 5-year follow-up period.…”

“…These complications result in higher-order aberrations and a deterioration of visual quality 24 . In contrast, R-IOL implantation may result in small SE variations (− 0.50 to − 0.94 D) but, it has a low risk of inducing IOL tilt 12,17 , as new needle sclerotomies would not be required for R-IOL. The mean surgically induced astigmatism after a 5.5 mm scleral incision for R-IOL implantation has been shown to be as subtle as + 0.65 D at 171°2 5 .…”

“…In addition, they did not perform total vitrectomy for all patients, which also may increase the risk of CME due to vitreomacular traction 19,40 . Recently, a 4.9% incidence of CME was reported for 122 eyes over a 7.5-month follow-up period, including cases in which CME was present preoperatively 17 . In contrast, patients with uveitis were not included in our study population, and all included patients underwent total pars plana vitrectomy.…”

“…In addition, the absence of sutures for IOL scleral fixation lowers the risk for suture-related complications, such as conjunctival erosion, scleromalacia, and endophthalmitis 9,10 . Many previous studies have shown that secondary R-IOL is a safe and efficacious technique for correcting various aphakic conditions with [11][12][13][14][15][16][17] or without IOL dislocation 3,18 . However, the long-term safety and efficacy of simultaneous primary R-IOL implantation and vitrectomy in patients with complete IOL dislocation have not been previously assessed.…”