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@#AIM: To compare the curative effect of retropupillary iris claw intraocular lens(IOL)implantation and posterior chamber ciliary scleral suture fixed IOL in the aphakic eyes without capsular support.<p>METHODS: The present retrospective study included 70 aphakic eyes without capsular support. According to the different surgical methods, the patients were divided into two groups, including group A(35 eyes)with treatment of retropupillary iris claw IOL implantation, group B(35 eyes)with treatment of posterior chamber ciliary scleral suture fixed IOL. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell density(CECD)of the two groups were documented and compared before operation and 3d, 1, 3, 6mo and 1a after operation. Furthermore, the stability of IOL in both groups, as well as the intraoperative and postoperative complications were recorded.<p>RESULTS: The patients in the present study were followed up for 12 to 14mo. 3d after surgery, UCVA in group A was significantly improved compared with that before surgery(<i>P</i><0.01), while BCVA had no difference compared with that before surgery(<i>P</i>=0.073).UCVA in group B showed no difference(<i>P</i>=0.097), while BCVA was worse(<i>P</i>=0.002). UCVA and BCVA in both groups were significantly elevated 1mo after surgery(<i>P</i><0.05), and remained stable 6, 3mo later,respectively. Furthermore, IOP in both groups remained in normal level during the follow up period, 0.7% and 2.3% reduction of CECD in A group and B gruop was observed at 1a after operation respectively(<i>P</i><0.05). Both IOP and CECD between the two groups have no significant differenc at each time point during the follow up period(<i>P</i>>0.05).There was no significant difference between whole eye astigmatism and corneal astigmatism in A group and B gruop at 1 and 6mo after operation(<i>P</i>>0.05). Additionally, There was 1 case of IOL dislocation in each group after operation, which was further recovered by operation. Significant tilt and deviation of IOL were not observed in the rest of the patients during the follow up period. The other postoperative complications were mild with no difference in complications between the two groups(<i>P</i>>0.05).<p>CONCLUSION: For aphakic eyes without capsular support, both retropupillary iris claw IOL implantation and posterior chamber ciliary scleral suture fixed IOL are safe and effective surgical methods. Retropupillary iris claw IOL implantation has relatively simple operation, lower damage to the eyeball tissue, the shorter operation time, and the quicker recovery of postoperative visual acuity, which is one of the effective clinical treatments.
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@#AIM: To analyze the efficacy of iris-claw intraocular lens(ICIOL)and scleral-fixator intraocular lens(SFIOL)in terms of visual outcomes, surgical time, and postoperative complications in the aphakic patients.<p>METHODS: This study was a prospective study with 60 aphakic eyes of 60 patients who attended our outpatient department from October 2018 to February 2020. These patients were divided into two groups and each with 30 patients. Patients in Group I were underwent ICIOL whereas patients in Group II underwent SFIOL implantation. Patients with pre-existing ocular pathologies, previous history of retinal surgery of the eye were excluded. The preoperative and postoperative evaluation was done for the follow up period of 9mo.<p>RESULTS: Twenty-six(87%)patients in the ICIOL group and 24(80%)patients in SFIOL group had best corrected visual acuity(BCVA,LogMAR)with 0.50-0.00 after 9mo follow up. The mean of BCVA(LogMAR)was comparable in both the groups. The surgical time in ICIOL was significantly less than the SFIOL group(<i>P</i><0.01). Complications related to sutures were significantly more in the SFIOL group. Complications found in the ICIOL group were very mild and harmless. <p>CONCLUSION: The visual outcome was comparable in both groups. ICIOL with fewer complications and requiring less surgical time was found to be a better alternative to SFIOL in the correction of aphakia.
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Aim: To study the efficiency and safety of iris reconstruction combined with iris‑claw intraocular lens (IOL) implantation in the patients with iris‑lens injuries. Settings and Design: Retrospective, noncomparable consecutive case series study. Materials and Methods: Eleven patients (11 eyes) following iris‑lens injuries underwent iris reconstructions combined with iris‑claw IOL implantations. Clinical data, such as cause and time of injury, visual acuity (VA), iris and lens injuries, surgical intervention, follow‑up period, corneal endothelial cell count, and optical coherence tomography, were collected. Results: Uncorrected VA (UCVA) in all injured eyes before combined surgery was equal to or <20/1000. Within a 1.1–4.2‑year follow‑up period, a significant increase, equal to or better than 20/66, in UCVA was observed in six (55%) cases, and in best‑corrected VA (BCVA) was observed in nine (82%) cases. Postoperative BCVA was 20/40 or better in seven cases (64%). After combined surgery, the iris returned to its natural round shape or smaller pupil, and the iris‑claw IOLs in the 11 eyes were well‑positioned on the anterior surface of reconstructed iris. No complications occurred in those patients. Conclusions: Iris reconstruction combined with iris‑claw IOL implantation is a safe and efficient procedure for an eye with iris‑lens injury in the absence of capsular support.