title: Primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide in cases of inadequate capsular support.
abstract: OBJECTIVE
  To assess the outcomes and analyze complication rates following primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide.
  
  
  METHODS
  This is a retrospective interventional case series. Patients with poor capsular support-diagnosed preoperatively or owing to intraoperative complications-were treated with iris claw IOL retrofixation with intravitreal triamcinolone acetonide. The data were retrospectively analyzed.
  
  
  RESULTS
  104 eyes of 102 patients with poor capsular support who underwent the procedure between 2010 and 2013 were analyzed. The minimum follow-up period was 12 months (ranging from 12 to 36 months). Iris claw IOL was implanted in-traumatic subluxated cataracts-24 cases (23.07%), non-traumatic subluxated cataracts in 16 cases (15.38%), or as a complication of cataract surgery-intraoperative posterior capsular rent in 48 cases (46.15%) and intraoperative nucleus drop in 16 cases (15.38%). The final mean best-corrected logMAR visual acuity improved from 1.36 ± 0.64 preoperatively to 0.36 ± 0.32 at 1-year follow-up. Complications included pupil ovalization in 11 cases (10.57%), transient elevation in intraocular pressure in 7 eyes (6.73%), postoperative hypotony in 5 eyes (4.80%), cystoid macular edema in 2 eyes (1.92%), retinal detachment in 1 eye (0.96%), vitreous hemorrhage in 1 eye (0.96%), and hyphema in 1 eye (0.96%).
  
  
  CONCLUSIONS
  Primary iris claw IOL retrofixation provided excellent alternative in patients with inadequate capsular support. The visual outcomes were good along with favorable rates of complications. The addition of triamcinolone acetonide helps in reducing the chances of cystoid macular edema.
authors.affiliation: National Institute of Ophthalmology, 1187/30, Off Ghole Road, Near Phule Museum, Shivaji Nagar, Pune, 411005, India. adityapune4@gmail.com.
authors.forename: Aditya
authors.initials: A
authors.lastname: Kelkar
authors.affiliation: National Institute of Ophthalmology, 1187/30, Off Ghole Road, Near Phule Museum, Shivaji Nagar, Pune, 411005, India.
authors.forename: Rachana
authors.initials: R
authors.lastname: Shah
authors.affiliation: Raghudeep Eye Clinic, Near Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, Gujarat, 380052, India.
authors.forename: Viraj
authors.initials: V
authors.lastname: Vasavda
authors.affiliation: National Institute of Ophthalmology, 1187/30, Off Ghole Road, Near Phule Museum, Shivaji Nagar, Pune, 411005, India.
authors.forename: Jai
authors.initials: J
authors.lastname: Kelkar
authors.affiliation: National Institute of Ophthalmology, 1187/30, Off Ghole Road, Near Phule Museum, Shivaji Nagar, Pune, 411005, India.
authors.forename: Shreekant
authors.initials: S
authors.lastname: Kelkar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008269:Macular Edema / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide
keywords: Cystoid macular edema; Iris claw IOL; Iris claw IOL retrofixation; Triamcinolone acetonide