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Background@#Surgical correction of aphakia without capsular support continues to be a challenge. Improvements in the technology of cataract surgery have provided advancements in techniques in surgical management of aphakia. Locally, we have limited data on the outcomes of the different intraocular lenses used in aphakia.@*Objective@#This study aimed to determine visual outcomes and complications associated with different techniques of intraocular lens implantation in the absence of capsular support.@*Methods@#We reviewed the medical charts of 207 patients who underwent intraocular lens implantation without capsular support. Excluded were patients with incomplete follow up, pediatric patients, and lost records. Best corrected visual acuity at day 1, 1st month, 3rd month and 6th month postoperatively, and the complications were noted.@*Results@#Mean age was 60 and 51% (n=105) were females. The mean follow-up time was 9.33 ± 0.71 months. Loss of capsular support was most frequently caused by intraoperative complication (n=146, 70%) and trauma. Retropupillary fixation iris claw intraocular lens was frequently used (n=93, 44.9%). Across all patients, visual acuities showed excellent outcomes with 20/50 or better. Across IOL types, the most frequent postoperative complication was increase in IOP. Statistically significant results were set at P <0.05. @*Conclusion@#There is a notable preference towards iris claw retropupillary lenses through time. Iris claw lenses showed the shortest operative time. All intraocular lenses used in aphakia showed comparably good postoperative visual acuities, except for the superior visual acuity trend seen among retropupillary iris claw and anterior chamber IOL groups. Complications included elevated intraocular pressures, corneal edema, and pigment dispersion.
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Afaquia , FilipinasRESUMEN
Purpose: To assess different approaches in the management of aphakia in adults in Indian ophthalmologists via an online survey. Methods: A survey-monkey based online questionnaire was fielded to Indian ophthalmologists in accordance with the CHERRIES guidelines. We recorded participants’ demographics, practice settings, and preferred surgical options including the type of intraocular lens (IOL) preferred when encountering a case of aphakia in adults with and without adequate capsular support. Differences between anterior segment (AS) surgeons and vitreoretinal (VR) surgeons as well as differences between surgeons with more or less than 10 years of surgical experience were evaluated using analytic statistics. Results: Of the 481 surgeons who responded to the survey, 369 (77%) were AS surgeons and the remaining 112 (23%) were VR surgeons and represented all regions of India. When encountering posterior capsular rent during cataract surgery, a three-piece IOL in the ciliary sulcus was the most preferred (n = 275, 57%) when there was adequate capsular support, while a retrofixated iris-claw IOL (n = 91, 19%) was the commonest choice in eyes without adequate capsular support. With associated nucleus drop, 85% of surgeons preferred to refer the patient to a VR surgeon and left the eye aphakic. Multivariable logistic regression showed that VR surgeons were more than six times likely to prefer a scleral fixated intraocular lens (SFIOLs) [odds ratio (OR) = 6.5, 95% confidence interval (CI) = 3.4–12.5, P < 0.001] and surgeons with >10 years of experience were also twice more likely to prefer an SFIOL (OR = 2.4, 95% CI = 1.2–4.9, P = 0.02). Conclusion: The choice of IOL in absence of capsular support in adult eyes differs between AS and VR surgeons and is also influenced by the surgeon’s experience.
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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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Among 20 million cataract surgeries being performed worldwide every year, approximately 5% are being complicated by posterior capsule rent or zonular dialysis. Intraocular lens (IOL) implantation in such cases with intraoperative complications is quite challenging. Our next course of action is to place the IOL in the ciliary sulcus, however, there is a risk of IOL drop into the vitreous in cases of inadequate support. We have described a novel idea of using a suture material through the dialling hole of a three-piece rigid IOL which can be used as a leash to reduce the risk of IOL drop during implantation in such cases. This technique could also be used during sutureless scleral fixated IOL and retro-pupillary iris claw lens implantation. We found that in 90 consecutive patients where this technique was used, there was no incidence of IOL drop or retinal detachment.
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Purpose: To evaluate the outcomes of implantation of an iris-claw intraocular lens (IC-IOL) in retropupillary position in aphakic patients. Methods: We conducted a prospective interventional study, including 36 aphakic eyes with inadequate capsular support. The postoperative examination included best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central corneal thickness (CCT), and anterior segment examination with emphasis on the anterior chamber reaction and shape of pupil. Follow-up was done for 3 months. Results: Thirty-six eyes of 34 patients, including 22 right eyes and 14 left eyes were included. Indications for surgery were complicated cataract surgery in 38.9% (n = 14), aphakia in 27.8% (n = 10), pseudophakic bullous keratopathy in 16.7% (n = 6), dislocated posterior chamber IOL (PCIOL) in 11.1% (n = 4), IC drop in 2.8% (n = 1), and subluxated PCIOL in 2.8% (n = 1). Postoperatively, the visual acuity improved by at least two lines in 32 (88.9%) and worsened in four (11.1%) eyes at the end of three months. Mean postoperative IOP at the end of the third month was 12.42 mmHg (standard deviation [SD] 2.57; range 11.55�.29 mmHg). The mean postoperative CCT at the end of the third month was 542.42 microns (SD 13.77; range 537.76�7.07 microns). Sixteen eyes (44.4%) had horizontally oval pupil, eleven eyes (30.6%) had round pupil, and nine eyes (25%) had irregular pupil. Twenty-three eyes (63.9%) presented with significant anterior chamber reaction and seven eyes (19.4%) had corneal stromal edema on postoperative day 1. Conclusion: Our study demonstrated that retropupillary IC-IOL implantation in eyes without adequate capsular support is an effective and safe procedure with a good visual outcome and fewer complications.
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Background: Japanese encephalitis (JE) vaccination in India started in 2006 with SA-14-14-2 live attenuated JE vaccine (JEV) following large outbreaks of JE in some districts of Eastern Uttar Pradesh and Bihar in 2005. Age groups 1-15 yrs are first vaccinated with a single dose of JEV in a campaign mode followed by integration of this vaccine in routine immunization. It is beyond doubt that added to vaccination campaigns, proper awareness on JE can play significant role in controlling the disease.Methods: An observational study with cross sectional design was conducted in Kolkata Medical College and Hospital, Kolkata during JE Vaccination campaign during January, 2018 among 85 respondents, to assess the awareness on JE, among care-givers who brought their children for vaccination at the immunization clinic.Results: It was found that only 37.6% the respondents attending the campaign knew the name of the disease; 17.6% respondents were aware about disease transmission, and 5.9% could state two or more clinical features that might be associated with Japanese Encephalitis. 69.4% had no knowledge of up to what age JE vaccines can be administered; 23.5% said it can be administered till the beneficiaries attain fifteen years of age.Conclusions: IEC activities during JE vaccination campaign was not able raise awareness on JE to the desired level. However beneficiaries were informed about service availability and could be mobilised to come for vaccination.
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Purpose: To compare the visual outcome and complications of retropupillary fixated iris claw intraocular lens (IOL) and sutureless intrascleral IOL fixation using the flanged fixation technique at 1 year. Methods: In this retrospective study, eyes that underwent either iris claw or flanged SFIOL from January 2016 to July 2017 with a minimum of 1-year follow-up were enrolled. Improvement in visual acuity, intraocular pressure measurements, endothelial cell count, central macular thickness, and complications were compared between and within groups at 6 weeks, 3 months, and 1 year postoperatively. Results: Data from 150 eyes were analyzed (n = 90 in the iris claw group and n = 60 in the flanged SFIOL group). Posterior capsular rent was the most common indication for IOL implantation (n = 51, 34%). The iris claw and SFIOL groups were comparable in terms of demographics and baseline characteristics. There was significant improvement in uncorrected distance visual acuity (UCDVA) at 6 weeks in both groups (P = 0.77), and at 1 year, the UCDVA was comparable between groups (0.36 ± 0.32 in the iris claw group and 0.30 ± 0.28 in the SFIOL, P= 0.75). Transient elevation of intraocular pressure was seen slightly more in eyes with SFIOL (17%), while ovalization of the pupil was the main sequelae seen in the iris claw group (20%). Conclusion: Both iris claw IOL fixation and SFIOL using flange are viable options for surgical correction of aphakia. Visual outcomes are excellent at 6 weeks and are maintained till 1-year follow-up, and complication rates are acceptably low, although ovalization of pupil is common with iris claw IOLs.
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Purpose: To compare the visual outcomes and complications between the eyes receiving retropupillary iris claw intraocular lens (IOL) and scleral-fixated IOL (SFIOL) for post-cataract aphakia. Methods: Medical records of consecutive patients who had iris claw IOL and SFIOL surgery from January 2010 to March 2015, with > 1 year of follow up were retrospectively analyzed. The surgical technique was based on individual surgeon preference. The best-corrected distance visual acuity (BCDVA), previous surgery, surgical technique, and complications were analyzed. Results: Retropupillary iris claw IOL was fixated in 48 eyes (46%) and SFIOL was performed in 56 eyes. Iris claw was performed more frequently at the time of primary cataract surgery (56%) compared to SFIOL (14%) (P < 0.001). At 1 month postoperative, BCDVA was significantly better in the SFIOL group [0.7 ± 0.5 logarithm of minimum angle of resolution (logMAR) in iris claw vs. 0.3 ± 0.2 logMAR in SFIOL, P < 0.001] but this difference did not persist at 1 year (0.4 ± 0.4 logMAR in iris claw vs. 0.3 ± 0.2 logMAR in SFIOL, P = 0.56). Eyes with iris claw IOL experienced significantly more postoperative iritis (17%), intraocular pressure spikes (10%), and ovalization of the pupil (16%). Conclusion: Retropupillary iris claw IOL fixation is as safe as SFIOL for visual rehabilitation of post-cataract aphakia. Visual rehabilitation following iris claw IOL might take longer than SFIOL. Ovalization of the pupil is the commonest adverse effect reported with this type of IOL design.
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In this new technique of cataract surgery in patients with iris-fixated phakic intraocular lens with cataract, phakic IOL is explanted at the end of surgery. Phakic IOL remains stable and securely enclaved to the iris during phacoemulsification which is performed through a small 2.2 mm incision. Endothelial protection is provided by viscodispersive OVD above the phakic IOL and space for surgery is created by high molecular weight viscocohesive OVD beneath the phakic IOL. This technique provides significant advantages from the previously described techniques in terms of chamber stability, endothelial protection, iris trauma and surgical ease.
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Objective To observe the effect of implantation of iris-claw intraocu lax lens combined with pupil reconstruction on aphakic eyes caused by ocular trauma.Methods The clinical data of 17 patients (17 eyes) of aphakic eyes treated with irisclaw intraocular lens implantation and pupil reconstruction were analyzed retrospectively,and the visual acuity,corneal endothelial cell count,intraocular pressure,intraocular lens location,pupil condition and postoperative complications were observed.Results Intraocular lens were implanted and pupils were repaired in all 17 patients (17 eyes) successfully,with no complications of intraocular lens dislocation and corneal decom pensation.The postoperative uncorrected visual acuity (0.52 + 0.17) was better than the preoperative visual acuity (0.04 + 0.02) and preoperative best corrected visual acui ty (0.44 +0.13).The corneal endothelial cell count was (1993.88 + 127.24) mm-2 6 months after operation,which was lower than that of preoperative date (2178.88 + 132.61)mm-2 (P ＜ 0.05).Preoperative intraocular pressure (15.91 + 2.73) mmHg (1 kPa =7.5 mmHg) was not significantly different from postoperative intraocular pressure (16.69 + 2.61) mmHg (1 kPa =7.5 mmHg) (P ＞ 0.05).The postoperative pupil size [(4.4 + 0.2) mm] was smaller than that of preoperative date [(5.5 + 0.3) mm] (P ＜ 0.05).The symptoms of photophobia,glare and diplopia did not occur postoperatively.Conelusion Pupil reconstruction combined with iris-claw intraocular lens implanta tion is a safe and effective method for aphalic eyes combined with absence of capsule support and ruptured iris.
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Objective To observe the effect of implantation of iris-claw intraocu lax lens combined with pupil reconstruction on aphakic eyes caused by ocular trauma.Methods The clinical data of 17 patients (17 eyes) of aphakic eyes treated with irisclaw intraocular lens implantation and pupil reconstruction were analyzed retrospectively,and the visual acuity,corneal endothelial cell count,intraocular pressure,intraocular lens location,pupil condition and postoperative complications were observed.Results Intraocular lens were implanted and pupils were repaired in all 17 patients (17 eyes) successfully,with no complications of intraocular lens dislocation and corneal decom pensation.The postoperative uncorrected visual acuity (0.52 + 0.17) was better than the preoperative visual acuity (0.04 + 0.02) and preoperative best corrected visual acui ty (0.44 +0.13).The corneal endothelial cell count was (1993.88 + 127.24) mm-2 6 months after operation,which was lower than that of preoperative date (2178.88 + 132.61)mm-2 (P ＜ 0.05).Preoperative intraocular pressure (15.91 + 2.73) mmHg (1 kPa =7.5 mmHg) was not significantly different from postoperative intraocular pressure (16.69 + 2.61) mmHg (1 kPa =7.5 mmHg) (P ＞ 0.05).The postoperative pupil size [(4.4 + 0.2) mm] was smaller than that of preoperative date [(5.5 + 0.3) mm] (P ＜ 0.05).The symptoms of photophobia,glare and diplopia did not occur postoperatively.Conelusion Pupil reconstruction combined with iris-claw intraocular lens implanta tion is a safe and effective method for aphalic eyes combined with absence of capsule support and ruptured iris.
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Context: Surgical outcome of retropupillary fixation of iris claw lens. Aims: To evaluate the various indications, intra and post‑operative complications, and visual outcome of retropupillary fixation of iris claw lens in aphakic eyes. Settings and Design: The study design is a retrospective study at a tertiary eye care center. Methods: Review of medical records of 61 aphakic eyes of 61 patients, who were rehabilitated with retropupillary fixation of an iris claw lens, with a follow‑up duration of at least 1 year. Statistical Analysis Used: Data analysis was performed using paired t‑test and Chi‑square test. Results: Mean preoperative uncorrected visual acuity was 1.66 ± 0.3 LogMAR and postoperative acuity at 1 year was 0.53 ± 0.5 LogMAR (P = 0.00001). Preoperative distant best‑corrected visual acuity was 0.30 ± 0.48 LogMAR and postoperative acuity at 1 year was 0.27 ± 0.46 LogMAR (P = 0.07). Mean preoperative astigmatism was 1.43 ± 1.94 D and postoperatively was 1.85 ± 2.16 D (P = 0.0127). Mean endothelial cell count was 2353.52 ± 614 cells/mm² preoperatively which decreased to 2200 ± 728 cells/mm² at 1 year follow‑up (P = 0.006). There was no significant difference in central macular thickness and intraocular pressure pre and post-surgery. Complications included ovalization of pupil in 9.83%, hypotony in 1.63%, toxic anterior segment syndrome in 1.63%, cystoid macular edema in 11.47%, epiretinal membrane in 3.27%, and iris atrophy in 6.55%. Conclusion: Iris claw is a safe and an effective method of rehabilitating aphakic eyes.
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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.
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Implantation of iris-claw Artisan intraocular lens (IOL) is a surgical option for correction of aphakia; however, these IOLs have not been used in eyes with uveitis including Fuchs’ heterochromic iridocyclitis (FHI) due to possible risk of severe postoperative intraocular inflammation. In the case reported here, we secondarily implanted an Artisan IOL in a 28-year-old man with FHI who had aphakia with no capsular support due to a previous complicated cataract surgery. Enclavation was easily performed and no intraoperative complication was noted. Postoperative course was uneventful with no significant anterior chamber inflammation during 12 months of follow-up. Although there were few deposits on the IOL surface, the patient achieved a best-corrected visual acuity of 20/20 without developing glaucoma or other complications. Therefore, Artisan IOL may be considered for correction of aphakia in patients with FHI. However, studies on large number of patients are required to evaluate safety of the procedure.
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To evaluate the safety and efficacy of iris claw intraocular lens (IOL) implantation for correction of monocular surgical aphakia in eyes with no capsular support. This is a prospective interventional case series of 30 eyes of monocular surgical aphakia. Patients underwent posterior iris claw implantation 4 weeks after the primary surgery. Aphakia which resulted due to posterior capsular rupture, large zonulo-dialysis (>180°) and cases of intracapsular cataract extraction in subluxated cataractous lens (>180°) where a posterior chamber IOL could not be placed were included in this study. Postoperatively, best-corrected visual acuity (BCVA) improved significantly (P < 0.02), 80% of patients had good vision of (20/20 to 20/40) and endothelial cell loss was 8.96% at 6 months. Secondary iris claw intraocular lens implantation is a viable option to correct monocular aphakia in eyes without capsular support.
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PURPOSE: To evaluate the effects of prone positioning on the critical distance (CD) in Artiflex (Ophtec BV) foldable anterior iris-claw phakic intraocular lens (pIOL)-implanted eyes. METHODS: Twenty patients with 40 Artiflex-implanted eyes were prospectively enrolled in the present study. The nasal and temporal critical distances (CD) were measured with Visante anterior segment optical coherence tomography (OCT, Carl Zeiss, Dublin, CA) in both the sitting and prone positions. RESULTS: The mean nasal CD was 1.52 +/- 0.15 mm in the sitting position and 1.49 +/- 0.13 mm in the prone position (p = 0.01). The mean temporal CD was 1.63 +/- 0.17 mm in the sitting position and 1.63 +/- 0.16 mm in the prone position (p = 0.67). In a multiple regression analysis, the changes in nasal CD were positively correlated with anterior chamber volume (r = 0.27; p = 0.01) and negatively correlated with pupil size (r = -0.23; p < 0.01). CONCLUSIONS: Prone positioning can induce a decrease in the nasal CD in Artiflex-implanted patients, especially in subjects with small pupils and large anterior chamber volumes.
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Humanos , Cámara Anterior , Ojo , Miosis , Lentes Intraoculares Fáquicas , Posición Prona , Estudios Prospectivos , Pupila , Tomografía de Coherencia ÓpticaRESUMEN
We evaluated the safety and efficacy of pars plana vitrectomy (PPV) with primary posterior iris claw intraocular lens (IOL) implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.
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Anciano , Femenino , Estudios de Seguimiento , Migración de Cuerpo Extraño/cirugía , Humanos , Iris/cirugía , Lentes Intraoculares/efectos adversos , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugía , Estudios Retrospectivos , Agudeza Visual , Vitrectomía/métodosRESUMEN
PURPOSE:To investigate long-term endothelial changes in phakic eyes implanted with iris-claw phakic intraocular lens (IOL) (Artisan(R) lens Ophtec, Groningen, Netherlands) and to identify the associated factors. METHODS: Thirty-one eyes of 18 patients underwent Artisan phakic IOL implantation and were followed up for over 1 year. The authors retrospectively examined the endothelial cell density, percentage of hexagonal cells and coefficient of variation using the result of non-contact specular microscope. RESULTS: The mean endothelial cell loss was 0.9% at 23.9+/-9.44 months of the mean follow-up period. There was no statistically significant decrease in endothelial cell density (p=0.445). There was no statistically significant change in pleomorphism and polymegathism of the endothelial cells after the surgery. There was no statistically significant correlation between endothelial cell loss and anterior chamber depth (r2=0.0488, p=0.377). CONCLUSIONS: No clinically significant endothelial damage occurred after iris-claw phakic IOL implantation. However, special attention should be given to patients with shallow anterior chamber depth for iris-claw phakic IOL insertion to avoid unintended endothelial damage and long-term endothelial checkups using a specular microscope are critical for long-term protection of endothelial cells.
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Humanos , Cámara Anterior , Células Endoteliales , Endotelio Corneal , Ojo , Estudios de Seguimiento , Miopía , Lentes Intraoculares Fáquicas , Estudios RetrospectivosRESUMEN
PURPOSE: We compared the results of implanting an implantable contact lens (ICL) and an iris claw lens (Artisan(R) lens) in patients' wtih myopia and sought to determine a basis for choosing between the two lenses. METHODS: ICLs were implanted in 32 eyes of 18 patients, and Artisan(R) lenses were implanted in 40 eyes of 23 patients. Uncorrected visual acuity, refraction, endothelial cell density, intraocular pressure, and slit lamp measurements were taken for 12 months. RESULTS: All the patients had improved UCVA from the day after the operation until the 12th month. The mean spherical equivalent refraction at postoperative month 12 was -0.78+/-0.54D in the ICL group and -0.78+/-0.59D in the Artisan(R) lens group. In the same period, endothelial cell density loss was 5.34% in the ICL group but was not significant in the Artisan(R) lens group. There were no significant complications in either group. CONCLUSIONS: Both ICL and Artisan(R) lens implantation resulted in immediate visual improvement and stability of vision during the follow-up period. There was no significant difference in post-operative results. Further study will be needed to decide which lens is the better choice for delicate conditions in myopic patients.