title: [Endothelial cell loss after retropupillary iris-claw intraocular lens implantation].
abstract: BACKGROUND
  The aim of this study was to evaluate the indication, visual and refractive outcome, endothelial cell loss and complication rate after implantation of a posterior iris-claw aphakic intraocular lens (IOL).
  
  
  METHODS
  This retrospective study comprised 62 eyes of 56 patients without adequate capsular support undergoing posterior iris-claw aphakic IOL implantation (Verisyse™/Artisan®) between 2006 and 2012. Mean follow-up was 34 months (range from 13 to 78 months).
  
  
  RESULTS
  The IOLs were inserted during primary lens surgery in 11 phakic eyes (17.8 %), during an IOL exchange procedure for dislocated posterior chamber IOLs in 34 eyes (54.8 %), and as a secondary procedure in 17 aphakic eyes (27.4 %). The final best spectacle-corrected visual acuity (BSCVA) in logMAR (mean 0.24 ± 0.45) improved significantly (p < 0.001) compared to the preoperative BSCVA (mean 0.61 ± 0.65). The mean spherical equivalent improved from preoperative 7,25 ± 5,04 diopters (D) (range - 10.25 to + 16.0 D) to - 0.21 ± 1.01 D (range - 4.0 to 3.0 D) postoperatively. Mean central endothelial cell density was 1844 ± 690 cells/mm(2) preoperatively. After surgery mean endothelial cell density decreased statistically not significant with a loss of 5.5 % to 1743 ± 721 cells/mm(2) (p > 0.05) at last follow-up visit. Complications included cystoid macular oedema in 4 eyes (6.4 %), early postoperative hypotony in 2 eyes (3.2 %), pupil ovalisation in 2 eyes (3.2 %), traumatic iris-claw IOL disenclavation in 2 eyes (3.2 %) and spontaneous IOL disenclavation in one eye (1.6 %).
  
  
  CONCLUSIONS
  Retropupillar iris-claw IOL provides good visual and refractive outcomes with a low endothelial cell loss and can be used for a wide range of indications in eyes without adequate capsular support.
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: J
authors.initials: J
authors.lastname: Gonnermann
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: S
authors.initials: S
authors.lastname: Amiri
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Klamann
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: A-K B
authors.initials: AK
authors.lastname: Maier
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: A M
authors.initials: AM
authors.lastname: Joussen
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: P W
authors.initials: PW
authors.lastname: Rieck
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: N
authors.initials: N
authors.lastname: Torun
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Bertelmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011474:Prosthesis Design; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult