Efficacy Of Iris-Claw Intraocular Lens Implantation For Aphakic Eyes Without Capsular Support

Purpose: To compare the curative effect of retropupillary iris claw intraocular lens（IOL）implantation and posterior chamber ciliary scleral suture fixed intraocular lens in the aphakic eyes without capsular support.Methods: The present retrospective study included 70 aphakic eyes without capsular support.According to the different surgical methods,the patients were divided into two groups,including group A（35 eyes）with treatment of retropupillary iris claw IOL implantation,group B（35 eyes）with treatment of posterior chamber ciliary scleral suture fixed IOL.The uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,intraocular pressure（IOP）and corneal endothelial cell density（CECD）of the two groups were documented and compared before operation and 3 days,1 month,3 months,6months and 1 year after operation,as well as whole eye astigmatism and corneal astigmatism 1 month,3 months after operation.Furthermore,The chamber angle,ciliary body and IOL position were examined by ultrasound biomicroscopy（UBM）,and pupil,iris,cornea,anterior chamber and IOL position were observed by slit lamp microscopy.The postoperative stability of IOL in both groups,as well as the intraoperative and postoperative complications were recorded.Results: The patients in the present study were followed up for 12 to 14 months.UCVA in A group was significantly improved compare with that before surgery（P<0.01）,while BCVA had no difference compared with that before surgery（P=0.073）.UCVA in B group show no dfference（P=0.097）,while BCVA was worse（P=0.002）.Moreover,UCVA and BCVA in both group were significantly elevated 1mo after surgery（P<0.05）,and remained stable 6 month,3 months later,respectively.Furthermore,IOP in both groups remained in normal level during the follow-up period,0.5% and 2.3%reduction of CECD in A group and B gruop was observed at 1 year after operation respectively（P<0.05）.Both IOP and CECD between the two groups have no significant difference at each time point during the follow-up period（P>0.05）.There was no significant difference between whole eye astigmatism and corneal astigmatism in A group and B group at 1 month and6 months after operation（P>0.05）.Additionally,there was 1 case of IOL dislocation in each group after operation,which was further recovered by operation.Significant tilt and deviation of IOL were not observed in the rest of the patients during the follow-up period.The other postoperative complications were mild with no difference in complications between the two groups.（P>0.05）.Conclusion: For aphakic eyes without capsular support,both retropupillary iris claw IOL implantation and posterior chamber ciliary scleral suture fixed IOL are safe and effective surgical methods.Retropupillary iris claw IOL implantation has relatively simple operation,lower damage to the eyeball tissue,the shorter operation time,and the quicker recovery of postoperative visual acuity,which is one of the effective clinical treatments.