A comparative study on retroiridal iris claw lens vs sutureless scleral fixated intraocular lens in the absence of capsular support

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Sunday 06/09/2015 | 10:30-12:30

Paper Time: 11:20

Venue: Room 10

First Author: : M.Mouttapa INDIA

Co Author(s): :    D. Babu   D. A                 

Abstract Details

Purpose:

To compare visual outcomes, rate of complications and ease of implantation of Retroiridal Iris Claw Lens (RICL) and Suture-less Scleral Fixated IOL (SSFIOL) in patients with inadequate capsular support. As a tertiary care hospital performing 41,000 cataract surgeries per year, two thirds of which are from outreach activities with advanced stages of cataract and also with the responsibility of training surgeons at different levels of experience, the quality of visual outcome and the ease of doing the secondary IOL implantation becomes very important in aphakic patients.

Setting:

Aravind Eye Hospital, Pondicherry, South India.

Methods:

This retrospective study reviewed 50 eyes in in the RICL group ( Artisan iris-fixated lens ) and 60 eyes in the SSFIOL group (3 piece PMMA lens). Patients with high Intra Ocular Pressure (IOP), pre-operative corneal and fundus pathology were excluded. The best corrected visual acuity, IOP and complications were compared between the two groups over a period of 2 months follow up. The ease of doing the procedure was also studied.

Results:

Post operative visual recovery at two months follow up with visual acuity better than or equal to 6/12 was 82% in the RICL group and 67% in the SSFIOL group (p= 0.069). In RICL group two patients (4%) had IOL decentration requiring no intervention. In SSFIOL group one patient (2%) had IOL decentration requiring resurgery for IOL centration, three patients (5%) had Rentinal detachments and three patients (5%) had cystoid macula edema (CME). IOP was normal in both the groups at two months follow-up. The time taken for the procedure was more in SSFIOL group (25 to 30 minutes) compared to the RICL group (8 to 12 minutes).

Conclusions:

The good visual outcomes and low incidence of postoperative complications in eyes with RICL indicate that these lenses should be considered an alternative to SSFIOL. Further the SSFIOL technique requires a long learning curve, costly instrumentation and more operating room time compared to the RICL technique. This study shows that the RICL technique gains more significance in the context ofdeveloping countries where scarce resouces compounded with a large number of rural population who present with advanced stages of cataract, resulting in high complication rate in surgery . A long term follow-up will add more strength to our conclusions.

Financial Interest:

NONE