title: Unilateral Iris-Claw Intraocular Lens Implantation for Aphakia: A Paired-Eye Comparison.
abstract: OBJECTIVE
  To perform a paired-eye comparison of secondary iris-claw intraocular lens (IOL) implantation for aphakia.
  
  
  METHODS
  Retrospective, comparative, nonrandomized interventional case series of aphakic eyes, which underwent secondary iris-claw Artisan IOL (Ophtec BV) implantation for aphakia in one eye and no surgery (group 1) or cataract surgery (group 2) in the fellow eye. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent, central endothelial cell count (cECC), and complications were evaluated before surgery, and at yearly intervals up to 5 years.
  
  
  RESULTS
  Thirty aphakic eyes implanted with the Artisan were included, and the fellow eyes served as controls. In group 1, postoperative logMAR UDVA and CDVA was significantly higher in the Artisan-implanted eyes (P < 0.01). In group 2, no differences were found in postoperative UDVA and postoperative CDVA between the Artisan-implanted eyes and the eyes that underwent cataract surgery throughout the follow-up (P ≥ 0.05). No statistically significant differences were found in postoperative spherical equivalent between the Artisan-implanted eyes and unoperated eyes or eyes that underwent cataract surgery (P ≥ 0.05). In group 1, cECC was significantly lower in the Artisan-implanted eyes [1973 ± 822 vs. 2616 ± 481 cells per square millimeter at 2 years (P < 0.01)] throughout the follow-up (P < 0.01). In group 2, cECC was not significantly lower in the Artisan-implanted eyes (P ≥ 0.05) [1934 ± 689 vs. 2058 ± 818 cells per square millimeter at 2 years (P = 0.67)].
  
  
  CONCLUSIONS
  Visual rehabilitation with secondary iris-claw IOL implantation in aphakic eyes without capsular support seems to be an effective and safe procedure. As expected, uncomplicated cataract surgery with posterior chamber IOL implantation showed lower endothelial cell count loss. Close monitoring of the corneal endothelium is mandatory.
authors: *Cornea and Refractive Surgery Unit, Instituto de Microcirugia Ocular, Barcelona, Spain; †Cornea, Refractive Surgery and Cataract Unit, Instituto de Microcirugia Ocular, Barcelona, Spain; ‡Department of Ophthalmology, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; §Universitat Autònoma de Barcelona, Barcelona, Spain; ¶Department of Mathematics, Universitat de Girona, Girona, Spain; and ‖Harvard University, Cambridge, MA.
authors: Jose L
authors: JL
authors: Güell
authors: Paula
authors: P
authors: Verdaguer
authors: Gloria
authors: G
authors: Mateu-Figueras
authors: Daniel
authors: D
authors: Elies
authors: Oscar
authors: O
authors: Gris
authors: Jose M
authors: JM
authors: Amich
authors: Felicidad
authors: F
authors: Manero
authors: Merce
authors: M
authors: Morral
mesh_terms: D000328:Adult; D000368:Aged; D001036:Aphakia, Postcataract / Q000503:physiopathology / Q000601:surgery*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology