Original article
Posterior Iris Fixation of the Iris-Claw Intraocular Lens Implantation through a Scleral Tunnel Incision

https://doi.org/10.1016/j.ajo.2007.06.009Get rights and content

Purpose

To evaluate the technique, efficacy, and safety of posterior iris fixation of iris-claw intraocular lens (IOLs) implantation through a scleral tunnel incision for aphakia correction.

Design

Noncomparative, interventional case series.

Methods

A secondary posterior iris fixation of the Artisan iris-claw IOL (Ophthec BV, Groningen, The Netherlands) was implanted for aphakia correction in the authors’ clinical practice. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), astigmatism, manifest refraction, lens position, pigment dispersion, and intraocular pressure (IOP) were evaluated in 32 consecutive eyes of 32 patients.

Results

BSCVA was 20/40 or better in 28 eyes (87.50%) during the mean follow-up time (nine months). Mean postoperative spherical equivalent was −0.70 diopters (D; standard deviation [SD], 0.47 D) at six months after surgery. Mean prediction error was −0.13 D (SD, 0.28 D), and mean absolute prediction error was 0.26 D (SD, 0.15 D). Preoperative mean astigmatism was −1.08 D (SD, 0.55 D; range, 0.0 to −2.0 D). At six months after surgery, mean astigmatism was −2.1 D (SD, 0.81 D; range, −0.75 to −3.75 D). There was no significant postoperative IOP increase. Lens position, evaluated by Oculus Pentacam (Pentacam 70700: Oculus, Wetzlar, Germany) and ultrasound biomicroscopy [UBM] (Ophthalmic Technologies Inc, Toronto, Ontario, Canada), was parallel to the iris plane.

Conclusions

Posterior iris fixation of the iris-claw IOL implantation through a scleral tunnel incision is a safe procedure and an effective option for aphakic eyes without capsule support.

Section snippets

Methods

This study concerned 32 eyes of 32 patients with ages ranging from 45 to 80 years (20 men, 12 women) who underwent iris-claw IOL implantation by the same surgeon (M.B.) between October 21, 2005 and August 14, 2006 at Uludag University, Bursa, Turkey. All patients were fully informed of the details and possible risks of the procedure, and informed consent was obtained from each patient before his or her inclusion in the study.

Inclusion criteria were as follows: complicated cataract surgery with

Results

Preoperative BSCVA was 20/40 or better in seven eyes (21.87%). At the first postoperative month, BSCVA was 20/40 or better in 15 eyes (46.87%), and at the second postoperative month, BSCVA was 20/40 or better in 26 eyes (81.25%). BSCVA was 20/40 or better in 28 eyes (87.50%) at the ninth postoperative month. Postoperative UCVA was equal to or better than preoperative BSCVA in 100% of eyes (32 eyes of 32 patients) at nine months of follow-up. All eyes in our series were noted to have a

Discussion

For decades, anterior10, 11 and scleral-fixated posterior12, 13 chamber IOLs have been the most popular type of lenses used in secondary IOL implantation in the absence of capsule support. In this series, we studied the posterior iris fixation of Artisan Aphakia iris-claw IOLs that have been used as a secondary IOL in aphakic patients. This surgical technique was designed to respect anterior segment anatomic features as closely as possible; the ideal position for the IOL after extracapsular

Mehmet Baykara, MD, received his medical degree and specialty training from Uludag University School of Medicine in Bursa, Turkey. He worked as a fellow at the The Rosen Eye Surgery Centre with Mr Emanuel S. Rosen in 2001. Dr Baykara has been working as an Associated Professor in Ophthalmology at the Uludag University School of Medicine. He specializes in cataract, refractive, glaucoma, and anterior segment surgery departments.

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Mehmet Baykara, MD, received his medical degree and specialty training from Uludag University School of Medicine in Bursa, Turkey. He worked as a fellow at the The Rosen Eye Surgery Centre with Mr Emanuel S. Rosen in 2001. Dr Baykara has been working as an Associated Professor in Ophthalmology at the Uludag University School of Medicine. He specializes in cataract, refractive, glaucoma, and anterior segment surgery departments.

Hikmet Ozcetin, MD, is a professor of Clinical Ophthalmology at Uludag University School of Medicine in Bursa, Turkey. He received his medical degree from Istanbul University School of Medicine and completed his Ophthalmology Residency at the Hacettepe University Hospital. In 1983, he worked as a fellow with Mr Fyodorov at Moscow Research Institute of Eye Microsurgery on radial keratotomy and clear lens surgery. Dr Ozcetin was involved in the establishment of the Turkish Society of Cataract and Refractive Surgery and became its director from 1990 to 1994 and 1998 to 2000. His research field has been radial keratotomy, phakic IOLs, and clear lens surgery. Dr Ozcetin has published more than 70 papers in international and national medical journals and has written five books, in Turkish, on cataract, myopia, and their managements.

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