Posters

Iris-claw vs scleral sutured IOLs and endothelial decompensation rates

Poster Details

First Author: A.Ng UK

Co Author(s):    I. Reekie   B. Ilango                 

Abstract Details

Purpose:

Iris-claw and scleral fixation of intra-ocular lenses (IOLs) are two commonly used methods of IOL implantation when there is a lack of capsular support. A well-known complication of intraocular surgery is damage to the corneal endothelium and corneal decompensation. It has been suggested that iris-claw IOLs may have a higher rate of corneal decompensation than the scleral fixation technique. We aimed to establish the relative rates of endothelial decompensation between an Iris Claw IOL cohort and a Scleral Fixated IOL cohort in our centre.

Setting:

A UK district general hospital providing comprehensive ophthalmology services to a population of around 500,000 people.

Methods:

A retrospective single-centre cohort case-note review. All patients undergoing iris claw or scleral fixated IOL implantation in the period June 2008 to December 2017 were included. Notes were examined for details of the indication for the procedure performed and for any complications. Visual acuity prior to IOL implantation and at most recent follow up were also recorded. The primary objective was to establish the proportion of patients experiencing corneal decompensation following surgery.

Results:

5 of 66 (7.58%) eyes with iris claw IOLs went on to corneal decompensation compared to 3 of 27 (11.11%) of the scleral sutured IOL cohort. However; two of the decompensated scleral sutured cohort were in corneal grafts, and the final case of corneal decompensation was an eye which had previously had an anterior chamber IOL. No cases of decompensation of previously healthy corneas were seen.

Conclusions:

In this study the scleral sutured IOL cohort had a higher rate of corneal decompensation that the iris-claw IOL group; however, this may have been as a result of poorer pre-operative condition of the patients’ corneas as no cases of decompensation of previously healthy corneas were seen in the scleral sutured IOL group.

Financial Disclosure:

None