Secondary iris claw intraocular lens anterior chamber implantation for the correction of aphakia

Poster Details

First Author: Z.Yuan CHINA

Co Author(s):    Q. Wu              

Abstract Details

Purpose:

To evaluate the safety and efficacy of iris claw intraocular lens anterior chamber implantation for correction of aphakia without capsular support.

Setting:

prospective clinical study

Methods:

Postoperative outcomes of secondary implantation of an iris-supported Artisan IOL in 9 unilateral aphakic patients were evaluated prospectively.Among these cases,there are 4 patients with previous pars plana vitrectomy secondary to penetrating ocular trauma,3 patients with previous fracture of suspensory ligament of lens during pha-demulsification surgery of cataract,1 patient with previous lens capsular broke during pha-demulsification surgery of cataract and 1 patient with posterior chamber intraocular lens fall into vitreous cavity completely. After complete ophthalmologic examination, IOL implantation was performed.Patients were followed for visual outcome, endothelial cell density (ECD) and occurrence of complications.Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA),spherical equivalents (SE),and ECD were compared before and after IOL insertion.All patients underwent ultrasound biomicroscop(UBM) and IOL master examinations to analyse the distance from IOL to cornea.

Results:

After 8-20 months(mean 15.3 months)follow-up,all cases postoperative uncorrected visual acuity significantly improved(preoperative 0.05±0.03,postoperative 0.32±0.19,t=4.63,P=0.0017).The best-corrected visual acuity no significant change (preoperative 0.41±0.29,postoperative 0.58 ±0.27, t=1.53,P=0.1652).Mean postoperative spheric equivalent at the last visit was 0.96±1.54D, and differ from the target spheric equivalent±2.0D.The surgically induced astigmatism(SIA) at the last visit was 2.11±0.56D.Mean postoperative endothelial cell density(ECD) was 1423.67±517.15 cell/mm2,preoperative ECD was 1560.89±552.41 cell/mm2,(t=2.79,P=0.0237 ).Mean endothelial cell density loss at the last visit was 10.9%.Postoperative mean distance from the peak of IOL front surface to centre internal surface of cornea was 2.63±0.96mm.Except one case has transient anterior chamber effusion reaction within one week after operation and one case happened the dislocation of the loop after operation,all case have no obvious postoperative complication.

Conclusions:

Secondary ARTISAN iris claw intraocular lens implantation is clinically safe and effective to correct aphakic eyes which lack of enough capsule support or exist suspensory ligament of lens disruption,though exist surgically induced astigmatism(SIA) in some cases. FINANCIAL DISCLOSURE?: No