Iris claw lens: anterior and posterior iris surface fixation in the absence of capsular support during penetrating keratoplasty.
BACKGROUND
Intraocular lens implantation in eyes with pseudophakic or aphakic corneal edema and insufficient posterior capsular support presents a surgical challenge. The iris claw lens has the advantage that it can be fixated to the iris without sutures because the peripheral iris is incarcerated between the claws.


METHODS
We present the results of a study with implantation of an iris claw lens in combination with penetrating keratoplasty in 19 eyes of 19 patients with pseudophakic or aphakic corneal edema which lacked posterior capsular support. The lens was fixated on the anterior iris surface (12 eyes) or posterior iris surface (seven eyes).


RESULTS
Mean follow-up time was 11.8 months (7 to 21 months). All grafts remained clear. One patient was lost for follow up after 3 months. Visual acuity improved in 83% of the patients. Twenty-eight percent of the patients had a visual acuity of > or = 20/40. Complications such as pigment dispersion, glaucoma, peripheral synechiae, and lens decentration were rare.


CONCLUSIONS
We feel iris claw lens implantation combined with penetrating keratoplasty is a safe alternative to achieve pseudophakia in eyes with corneal edema and inadequate posterior capsular support.
Rijneveld
W J
WJ
Eye Hospital Rotterdam, The Netherlands.
Beekhuis
W H
WH
Hassman
E F
EF
Dellaert
M M
MM
Geerards
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000601:surgery; D015715:Corneal Edema / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D007903:Lens Capsule, Crystalline; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D013536:Suture Techniques; D014792:Visual Acuity