title: Iris-claw intraocular lenses to correct aphakia in the absence of capsule support.
abstract: OBJECTIVE
  To evaluate the indications, postoperative visual efficacy, and complication rate after intraocular implantation of an iris-claw aphakic intraocular lens (IOL).
  
  
  METHODS
  Oxford Eye Hospital, Oxford, United Kingdom.
  
  
  METHODS
  Case series.
  
  
  METHODS
  This chart review comprised eyes with no capsule support that had anterior iris-fixation IOL implantation for aphakia between 2001 and 2009.
  
  
  RESULTS
  The study comprised 116 eyes (104 patients). Iris-claw IOLs were inserted during primary lens surgery in 18 eyes (15.5%), during an IOL exchange procedure for dislocated posterior chamber IOLs in 19 eyes (16.4%), and as a secondary procedure in 79 eyes (68.1%). The mean follow-up was 22.4 months (range 3 to 79 months). The final corrected distance visual acuity (CDVA) was 6/12 or better in 68.9% of all eyes and in 47 of 53 eyes (88.7%) with no preoperative comorbidity. Complications included wound leak requiring resuturing in 2.6% of eyes, postoperative intraocular pressure rise in 9.5% of eyes (glaucoma escalation 0.8%), and cystoid macular edema in 7.7% of eyes (0.8% chronic). Iris-claw IOL subluxation occurred in 6.0% of eyes from 5 days to 60 months postoperatively; all the IOLs were repositioned. Corneal decompensation occurred in 1.7% of eyes; 0.8% had retinal detachments.
  
  
  CONCLUSIONS
  Iris-claw IOL implantation for aphakia gave a good visual outcome and can be used for a wide range of indications. Postoperative complication rates were comparable to, if not better than, those with conventional anterior chamber IOLs. Correct implantation technique is critical in avoiding postoperative IOL subluxation.
authors.affiliation: Oxford Eye Hospital, Oxford, United Kingdom. samdesilva@doctors.org.uk
authors.forename: Samantha R
authors.initials: SR
authors.lastname: De Silva
authors.forename: Kikkeri
authors.initials: K
authors.lastname: Arun
authors.forename: Maghizh
authors.initials: M
authors.lastname: Anandan
authors.forename: Nicholas
authors.initials: N
authors.lastname: Glover
authors.forename: Chetan K
authors.initials: CK
authors.lastname: Patel
authors.forename: Paul
authors.initials: P
authors.lastname: Rosen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001036:Aphakia, Postcataract / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids