Visual rehabilitation in aphakia: a safe, simple and effective surgical procedure

Session Details

Session Title: Cataract Surgery Outcomes and Complications

Session Date/Time: Monday 07/09/2015 | 14:30-16:00

Paper Time: 15:18

Venue: Room 17

First Author: : S.Edakhlon INDIA

Co Author(s): :                        

Abstract Details

Purpose:

To evaluate the long term stability, safety and efficacy of retropupillary posterior iris fixation of iris claw lens in cases without adequate capsular support for placement of a posterior chamber (PC) intraocular lens (IOL) in the capsular bag or in the sulcus.

Setting:

Institution based study done at a tertiary eye care hospital, All the surgical procedures presented in this study were done by the same surgeon.

Methods:

A case series of 100 aphakic eyes of 100 patients with no capsular support who underwent retropupillary posterior iris fixation of iris were studied non comparatively. Two cases had undergone Vitreoretinal (VR) surgery for traumatic lens dislocation. Rest were post cataract surgery cases. Of these four cases had undergone VR surgery for nucleus drop and two for IOL drop. All the cases underwent secondary IOL implantation. Postoperative best corrected visual acuity (BCVA), intraocular pressure, tissue reaction, pigment dispersion and stability of IOL were studied at 1month, 3months, one year, two years ,three years, four years and five years.

Results:

Postoperatively all cases achieved BCVA equal to or better than preoperative BCVA. Two IOLs developed early disenclavation and were successfully reenclavated without any complication.All other IOLs were stable. Two of the post VR surgery cases developed retinal detachment between third and fourth years. There was no significant postoperative inflammatory reaction or surgically induced glaucoma in any of the cases. Three cases were lost to follow up by four years and another two by five years. In all the 95 cases that could be followed up for 5 years the retropupillaryposterior iris fixated intraocular lenses remained stable and well centred.

Conclusions:

Retropupillary posterior iris fixation of iris claw IOL is a safe and effective procedure for eyes without adequate capsular support for placement of a posterior chamber intraocular lens in the capsular bag or sulcus. Post Vitreoretinal surgery cases should be followed up more frequently and more carefully.

Financial Interest:

NONE