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Clinical outcome and endothelial loss following prepupillary and retropupillary implantation of iris claw intraocular lenses

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Abstract

Purpose

Iris claw intraocular lenses (IOLs) were successfully used for the management of aphakia in patients that lack capsular support. The aim of this study was to compare the clinical outcome of prepupillary and retropupillary implantation of these IOLs.

Methods

The files of the 26 patients that had an iris claw IOL implantation between 2010 and 2020 were retrospectively reviewed. Detailed ophthalmological examination findings including corrected distance visual acuity (CDVA), intraocular pressure, endothelial cell counts, slit lamp and dilated fundus examination findings were specifically tabulated. Intraoperative and postoperative complications were also specifically recorded.

Results

There were 18 patients in the prepupillary implantation group and eight patients in the retropupillary implantation group. Age and gender distribution were similar between the groups. CDVA significantly increased in prepupillary and retropupillary implantation groups (p = 0.001 and p = 0.012, respectively). Median endothelial cell loss was 6.7% in prepupillary group and 7.2% in retropupillary group. The only intraoperative complication was iridodialysis (n = 1). Postoperative complications included retinal detachment (n = 1), cystoid macular edema (n = 2) and IOL tilt (n = 1). All of these complications occurred in the prepupillary implantation group.

Conclusion

Prepupillary and retropupillary implantation of iris claw IOLs resulted with similar visual gain and endothelial loss rates in a follow-up time of 6 months. There was an insignificant trend toward a reduced complication rate following retropupillary implantation.

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Data availability

Data are available on reasonable request from the authors.

References

  1. Ozcan A, Ceran B (2014) Scleral fixation–where are we. Int J Ophthalmol Eye Rec 2:1–2

    Google Scholar 

  2. Werblin TP, Kaufman HE, Friedlander MH, Granet N (1981) Epikeratophakia: the surgical correction of aphakia: III. Preliminary results of a prospective clinical trial. Arch Ophthalmol 99(11):1957–1960. https://doi.org/10.1001/archopht.1981.03930020833002

    Article  CAS  PubMed  Google Scholar 

  3. Swinger CA, Barraquer JI (1981) Keratophakia and keratomileusis–clinical results. Ophthalmology 88(8):709–715. https://doi.org/10.1016/s0161-6420(81)34958-6

    Article  CAS  PubMed  Google Scholar 

  4. Grabner G (1991) Complications of epikeratophakia in correction of aphakia, myopia, hyperopia and keratoconus. Fortschr Ophthalmol 88(1):4–11

    CAS  PubMed  Google Scholar 

  5. Shammas HJ, Milkie CF (1978) Secondary lens implantation in aphakia: visual results and complications. J Am Intraocul Implant Soc 4(4):180–183. https://doi.org/10.1016/s0146-2776(78)80075-5

    Article  CAS  PubMed  Google Scholar 

  6. Davis DB 2nd (1989) Secondary IOL versus Epi-K. Indian J Ophthalmol 37(2):86–88

    PubMed  Google Scholar 

  7. Kang J, Cabot F, Yoo SH (2015) Long-term follow-up of epikeratophakia. J Cataract Refract Surg 41(3):670–673. https://doi.org/10.1016/j.jcrs.2014.11.035

    Article  PubMed  Google Scholar 

  8. Ding X, Yu Z (2018) Development of keratophakia and new research advances in lenticule transplantation. [Zhonghua yan ke za zhi] Chin J Ophthalmol 54(10):792–796

    CAS  Google Scholar 

  9. Amino K, Yamakawa R (2000) Long-term results of out-of-the-bag intraocular lens implantation. J Cataract Refract Surg 26(2):266–270

    Article  CAS  Google Scholar 

  10. Jayamadhury G, Potti S, Kumar KV, Kumar RM, Mishra KD, Nambula SR (2016) Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes. Indian J Ophthalmol 64(10):743

    Article  CAS  Google Scholar 

  11. Mularoni A, Imburgia A, Forlini M, Rania L, Possati GL (2020) In vivo evaluation of a one-piece foldable sutureless intrascleral fixation lens using ultrasound biomicroscopy and anterior segment optical coherence tomography. J Cataract Refract Surg. https://doi.org/10.1097/j.jcrs.0000000000000444

    Article  PubMed  Google Scholar 

  12. Vaiano AS, Hoffer KJ, Greco A, Greco A, D’Amico G, Pasqualitto V, Carlevale C, Savini G (2021) Long-term outcomes and complications of the new carlevale sutureless scleral fixation posterior chamber IOL. J Refract Surg 37(2):126–132. https://doi.org/10.3928/1081597X-20201207-02

    Article  PubMed  Google Scholar 

  13. Aykut V, Esen F, Sali F, Oguz H (2021) Refractive outcome of trocar-assisted sutureless scleral fixation with 3-piece intraocular lenses. Int Ophthalmol. https://doi.org/10.1007/s10792-021-01824-y

    Article  PubMed  PubMed Central  Google Scholar 

  14. Duchene M, Iscar C, Muraine M, Gueudry J (2020) Characteristics and management of uveitis-glaucoma-hyphema syndrome. J Fr Ophtalmol 43(3):205–210. https://doi.org/10.1016/j.jfo.2019.07.030

    Article  CAS  PubMed  Google Scholar 

  15. Tang Y, Xu J, Chen J, Lu Y (2020) Long-term destiny of corneal endothelial cells in anterior chamber intraocular lens-implanted eyes. J Ophthalmol 2020:5967509. https://doi.org/10.1155/2020/5967509

    Article  PubMed  PubMed Central  Google Scholar 

  16. de Rojas MV, Vina S, Gestoso A, Simon P, Alvarez M (2020) Intraocular lens explantation in Spain: indications and outcomes at a tertiary referral center from 2010 to 2018. Int Ophthalmol 40(2):313–323. https://doi.org/10.1007/s10792-019-01181-x

    Article  PubMed  Google Scholar 

  17. Choragiewicz T, Nowomiejska K, Haszcz D, Nowakowska D, Avitabile T, Reibaldi M, Junemann AGM, Toro MD, Rejdak R (2019) Transscleral fixation of black diaphragm intraocular lens in complete aniridia and aphakia due to posttraumatic eye rupture: a pilot study. J Clin Med. https://doi.org/10.3390/jcm8010046

    Article  PubMed  PubMed Central  Google Scholar 

  18. Choragiewicz T, Rejdak R, Grzybowski A, Nowomiejska K, Moneta-Wielgoś J, Ozimek M, Jünemann AG (2016) Outcomes of sutureless iris-claw lens implantation. J Ophthalmol 2016:1–7

    Article  Google Scholar 

  19. Shanida H, Narayan S, Rajini K (2018) Visual outcome and complications of posterior iris-claw intraocular lens implantation: a follow-up analysis. Kerala J Ophthalmol 30(2):107

    Article  Google Scholar 

  20. Toro MD, Longo A, Avitabile T, Nowomiejska K, Gagliano C, Tripodi S, Choragiewicz T, Kaminska A, Figus M, Posarelli C, Forlini M, Junemann AGM, Reibaldi M, Rejdak R (2019) Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: anterior chamber versus retropupillary implantation. PLoS ONE 14(4):e0214140. https://doi.org/10.1371/journal.pone.0214140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Tourino Peralba R, Lamas-Francis D, Sarandeses-Diez T, Martinez-Perez L, Rodriguez-Ares T (2018) Iris-claw intraocular lens for aphakia: can location influence the final outcomes? J Cataract Refract Surg 44(7):818–826. https://doi.org/10.1016/j.jcrs.2018.05.010

    Article  PubMed  Google Scholar 

  22. Mora P, Calzetti G, Favilla S, Forlini M, Tedesco S, Date P, Tagliavini V, Carta A, Frisina R, Pedrotti E, Gandolfi S (2018) Comparative analysis of the safety and functional outcomes of anterior versus retropupillary Iris-claw IOL fixation. J Ophthalmol 2018:8463569. https://doi.org/10.1155/2018/8463569

    Article  PubMed  PubMed Central  Google Scholar 

  23. Anbari A, Lake DB (2015) Posteriorly enclavated iris claw intraocular lens for aphakia: long-term corneal endothelial safety study. Eur J Ophthalmol 25(3):208–213. https://doi.org/10.5301/ejo.5000527

    Article  PubMed  Google Scholar 

  24. Esen F, Kostek M, Emekli AS, Eraslan M (2016) Double-organ bias in published randomized controlled trials of glaucoma. J Glaucoma 25(6):520–522. https://doi.org/10.1097/IJG.0000000000000369

    Article  PubMed  Google Scholar 

  25. Brunin G, Sajjad A, Kim EJ, de Oca IM, Weikert MP, Wang L, Koch DD, Al-Mohtaseb Z (2017) Secondary intraocular lens implantation: complication rates, visual acuity, and refractive outcomes. J Cataract Refract Surg 43(3):369–376

    Article  Google Scholar 

  26. Galvis V, Tello A, Miotto G, Rangel CM (2012) Artisan aphakic lens for cataract surgery in anterior megalophthalmos. Case Rep Ophthalmol 3(3):428–433. https://doi.org/10.1159/000346074

    Article  PubMed  PubMed Central  Google Scholar 

  27. Vounotrypidis E, Schuster I, Mackert MJ, Kook D, Priglinger S, Wolf A (2019) Secondary intraocular lens implantation: a large retrospective analysis. Graefes Arch Clin Exp Ophthalmol 257(1):125–134

    Article  CAS  Google Scholar 

  28. Acar N, Kapran Z, Altan T, Kucuksumer Y, Unver YB, Polat E (2010) Secondary iris claw intraocular lens implantation for the correction of aphakia after pars plana vitrectomy. Retina 30(1):131–139. https://doi.org/10.1097/IAE.0b013e3181b32eef

    Article  PubMed  Google Scholar 

  29. Baykara M, Ozcetin H, Yilmaz S, Timuçin OB (2007) Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am J Ophthalmol 144(4):586–591. https://doi.org/10.1016/j.ajo.2007.06.009

    Article  PubMed  Google Scholar 

  30. Güell JL, Velasco F, Malecaze F, Vázquez M, Gris O, Manero F (2005) Secondary artisan-verysise aphakic lens implantation. J Cataract Refract Surg 31(12):2266–2271

    Article  Google Scholar 

  31. Peralba RT, Lamas-Francis D, Sarandeses-Diez T, Martínez-Pérez L, Rodríguez-Ares T (2018) Iris-claw intraocular lens for aphakia: can location influence the final outcomes? J Cataract Refract Surg 44(7):818–826

    Article  Google Scholar 

  32. Guell JL, Verdaguer P, Elies D, Gris O, Manero F, Mateu-Figueras G, Morral M (2014) Secondary iris-claw anterior chamber lens implantation in patients with aphakia without capsular support. Br J Ophthalmol 98(5):658–663. https://doi.org/10.1136/bjophthalmol-2013-304035

    Article  PubMed  Google Scholar 

  33. Lett KS, Chaudhuri PR (2011) Visual outcomes following artisan aphakia iris claw lens implantation. Eye (Lond) 25(1):73–76. https://doi.org/10.1038/eye.2010.146

    Article  CAS  Google Scholar 

  34. De Silva SR, Arun K, Anandan M, Glover N, Patel CK, Rosen P (2011) Iris-claw intraocular lenses to correct aphakia in the absence of capsule support. J Cataract Refract Surg 37(9):1667–1672. https://doi.org/10.1016/j.jcrs.2011.03.051

    Article  PubMed  Google Scholar 

  35. Schallenberg M, Dekowski D, Hahn A, Laube T, Steuhl KP, Meller D (2014) Aphakia correction with retropupillary fixated iris-claw lens (Artisan)–long-term results. Clin Ophthalmol 8:137–141. https://doi.org/10.2147/OPTH.S55205

    Article  PubMed  Google Scholar 

  36. Forlini M, Soliman W, Bratu A, Rossini P, Cavallini GM, Forlini C (2015) Long-term follow-up of retropupillary iris-claw intraocular lens implantation: a retrospective analysis. BMC Ophthalmol 15:143. https://doi.org/10.1186/s12886-015-0146-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Faria MY, Ferreira NP, Pinto JM, Sousa DC, Leal I, Neto E, Marques-Neves C (2016) Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens. Int Med Case Rep J 9:261–265. https://doi.org/10.2147/IMCRJ.S116771

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sekundo W, Bertelmann T, Schulze S (2014) Retropupillary iris claw intraocular lens implantation technique for aphakia. Ophthalmologe 111(4):315–319. https://doi.org/10.1007/s00347-013-2852-8

    Article  CAS  PubMed  Google Scholar 

  39. Chen J, Zhu X (2016) Magnetic solid phase extraction using ionic liquid-coated core-shell magnetic nanoparticles followed by high-performance liquid chromatography for determination of Rhodamine B in food samples. Food Chem 200:10–15. https://doi.org/10.1016/j.foodchem.2016.01.002

    Article  CAS  PubMed  Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey

    Ebubekir Durmus, Fehim Esen & Halit Oguz

  2. Department of Ophthalmology, Haydarpasa Education and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Melda Yenerel

  3. Ophthalmology Clinic, NB Kadikoy Hospital, Istanbul, Turkey

    Huseyin Sanisoglu

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  1. Ebubekir Durmus
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  2. Fehim Esen
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Contributions

ED, FE, MY, HS and HO performed study conception and design; ED and HS contributed to acquisition of data; ED, FE, MY, HS and HO were involved in analysis and interpretation of data; ED, FE, and HS drafted the manuscript; MY and HO done critical revision.

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Correspondence to Ebubekir Durmus.

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Durmus, E., Esen, F., Yenerel, M. et al. Clinical outcome and endothelial loss following prepupillary and retropupillary implantation of iris claw intraocular lenses. Int Ophthalmol 41, 3961–3969 (2021). https://doi.org/10.1007/s10792-021-01965-0

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  • DOI: https://doi.org/10.1007/s10792-021-01965-0

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