title: Gravitational pseudoaccommodation in patients with aphakic iris-claw intraocular lenses.
abstract: To assess whether iris-claw intraocular lenses (IOLs) undergo gravitation-dependent changes in position and refraction.
  
  
  
  Tertiary referral center, Bern, Switzerland.
  
  
  
  Observational case study.
  
  
  
  Patients with a history of pars plana vitrectomy and IOL exchange with implantation of an aphakic iris-claw IOL (Artisan) were included in this study. Objective refraction was obtained with a handheld autorefractometer, and the IOL position was measured by ultrasound biomicroscopy with the patient prone, sitting, and supine.
  
  
  
  Twenty-one eyes of 19 patients with retropupilary IOLs (13) or prepupillary IOLs (8) were included. The mean spherical equivalent (SE) in the sitting position was -0.81 diopter (D) ± 0.95 (SD), and the mean distance from the endothelium to the anterior edge of the IOL was 3.35 ± 0.72 mm. The mean SE in the supine position was -0.61 ± 1.28 D, whereas the mean SE in the prone position was -1.34 ± 1.17 D (P = .0030). The IOL position changed from 3.50 mm in the supine position to 3.06 mm in the prone position (P < .0001).
  
  
  
  The aphakic iris-claw IOL was subject to significant movement related to gravity. The change in the refractive effect suggests that there is a degree of pseudoaccommodation caused by the forward shift of the aphakic IOL in the face-down position.
  
  
  
  None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Joel-Benjamin
authors.initials: JB
authors.lastname: Lincke
authors.affiliation: From the Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Miller
authors.affiliation: From the Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ebneter
authors.affiliation: From the Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: martin.zinkernagel@insel.ch.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Zinkernagel
mesh_terms: D001036:Aphakia, Postcataract; D006112:Gravitation; D006801:Humans; D007498:Iris; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity