Rajesh Goel1, Sukriti Upadhyay2, Akshi Agarwal3, Dharmesh Sharma4, Sunita Goyal5, Jitendra Ahuja6
BACKGROUND
Visual rehabilitation of aphakic patients include spectacle correction, contact
lenses, and primary or secondary intra ocular lens (IOL) implantation. Spectacles
are rarely used nowadays because of limited visual field, aniseikonia and peripheral
refractive errors. Contact lenses are other options for correcting aphakia but can
cause a lot of corneal complications. Options for correction of aphakic patients
with lack of adequate capsular support include anterior chamber IOL (ACIOL),
scleral fixated IOL (SFIOL), and iris fixated IOL. Implantation of a retropupillary
IC-IOL provides the benefits of a PCIOL, and the duration of the surgery is also
less. The retropupillary IC-IOL because of its position lowers the risk of endothelial
decompensation is a better option. We wanted to evaluate the functional outcomes
of retropupillary iris claw lens implantation.
METHODS
Secondary implantation of IC-IOL was done in 50 surgical aphakic eyes as a result
of intraoperative posterior capsular rent with zonular dialysis (N = 43, 86 %) &
large (> 7 clock hours) zonular dehiscence (N = 7, 14 %). Follow up was done on
1st day, 7th day, 1 month, 3 months and 6 months.
RESULTS
22 males and 28 females in the age group 40 - 78 years were operated. 78 %
eyes (N = 39) had vision better than 6 / 12 while only 10 % eyes (N = 5) had <
6 / 60 vision and the remainder 12 % (N = 6) had vision between 6 / 18 & 6 /
36. Complications like acute postoperative iritis (N = 18, 36 %) pupillary distortion
(N = 15, 30 %), pigment clumping (N = 10, 24 %), iris chaffing (N = 9, 21 %),
secondary glaucoma (N = 5, 12 %) and IOL decentration (N = 3, 7 %) were seen.
The mean difference in central endothelial counts before surgery and 6 months
after surgery was 109 cell / mm2 (5.92 %).
CONCLUSIONS
Iris claw lens gives the dual benefit of good visual acuity and less complication
rate in aphakic patients with lack of adequate capsular support.
