Safety and Efficacy of Retropupillary Fixation of Iris Claw Intraocular Lens versus Sutureless Scleral Fixated Intraocular Lens in the Management of Post Cataract Aphakia

Talat, Mohamed Moheb; Eliwa, El Sayed Mustafa; Abdelhafez, Younis Al-said; Hassan, Riad Elzahr

doi:10.21608/ijma.2024.271780.1937

	Safety and Efficacy of Retropupillary Fixation of Iris Claw Intraocular Lens versus Sutureless Scleral Fixated Intraocular Lens in the Management of Post Cataract Aphakia
International Journal of Medical Arts
Article 2, Volume 6, Issue 4, April 2024, Page 4248-4260 PDF (1.83 MB)
Document Type: Original Article
DOI: 10.21608/ijma.2024.271780.1937
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Authors
Mohamed Moheb Talat ¹; El Sayed Mustafa Eliwa²; Younis Al-said Abdelhafez¹; Riad Elzahr Hassan¹
¹Department of Ophthalmology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
²Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Abstract
Background: It is standard practice to implant a foldable, one-piece posterior chamber [PC] intraocular lens [IOL] into the capsular bag during uncomplicated cataract surgery. However, conditions like subluxated capsules, pseudo-exfoliation syndrome, and post-complicated cataract surgery can lead to aphakia without adequate capsular support. The aim of the work: This study aims to evaluate the effectiveness of two intraocular lens [IOL] techniques for the treatment of aphakia: scleral fixation and iris claw fixation. Patients and Methods: A prospective study of 40 eyes—20 were fixed with an iris claw IOL using the retropupillary technique and 20 were fixed with a PC IOL using the flanged scleral fixation technique. Results: The most common indication for IOL implantation was posterior capsular rent [n=25, 65%]. Demographics and baseline factors were similar between groups. Uncorrected distance visual acuity significantly improved in both groups at 6 months [p>.001] with no difference at final follow-up. In the iris claw group, 25% developed ovalization. Excessive IOP occurred in 1% and 3% of scleral fixation and iris claw cases, respectively. Iris atrophy affected 30% of iris claw cases. Cystoid macular edema complicated 3 scleral fixation cases. Conclusion: For aphakia, iris claw IOL fixation and scleral fixation provide good visual outcomes at 6 months with an acceptable safety profile.
Keywords
Aphakia; Flanged haptics; Scleral fixation; Iris claw


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