Comparison of Retropupillary Iris-clawIntraocular Lens Implantation and Transscleral Suture Fixation of an Intraocular Lens for Aphakic Eyes

摘要

Iris-claw intraocular lens and scleral-fixation of intraocular lens are the main options for the correction of aphakia with inadequate capsular support. It is still unclear which one is the most appropriate for the management of aphakic eyes without sufficient capsular support.Aim: We compared early post-operative visual function and complications after retropupillary Iris-Claw Intraocular Lens (IOL) implantation and transscleral sutured IOL fixation for the treatment of aphakia in eyes without adequate capsular support.Materials and Methods: This prospective study included 36 aphakic eyes without capsular support. Nineteen eyes underwent posterior chamber implantation of the iris-claw lens (iris-claw group) and 17 eyes underwent transscleral suture fixation of an IOL (transscleral fixation group). Best-Corrected Visual Acuity (BCVA), Intraocular Pressure (IOP), operating time, and complications were compared between the groups. Patients were evaluated pre-operatively and at one day, one week, one month, and three months post-operatively.Results: BCVA was better in the iris-claw than in the transscleral fixation group at post-operative day one (p=0.01), but the groups did not differ significantly at one week, one month, or three months post-operatively (p>0.05). The mean operating time in the iris-claw group was significantly shorter than that in the transscleral fixation group (p<0.001). The post-operative complications in the transscleral fixation group included elevated IOP (17.65%), hyphema (5.88%), and retinal detachment (5.88%). Complications in the iris-claw group included pupil distortion (21.05%), increased IOP (5.26%), spontaneous dislocation (5.26%), and cystoid macular oedema (5.26%).Conclusion: Secondary retropupillary implantation of an iris-claw lens allows earlier visual recovery and requires a shorter operating time than does transscleral suture fixation of an IOL. In the early post-operative period, both surgical procedures are efficient and relatively safe for treating aphakic eyes without a stable lens bag.