• Written By: Michael G. Haas, MD
    Comprehensive Ophthalmology

    This retrospective study of aphakic eyes without capsular support showed that iris-claw IOL implantation is effective and safe, yielding excellent refractive results and minimal complications.

    The study’s authors reviewed the charts of 128 aphakic eyes that underwent secondary iris-claw IOL implantation and had a minimum follow-up of one year. The mean follow-up was 41.8 months.

    BSCVA improved in 63 percent of eyes, with 45 percent ≥20/40 at one-year postop. Twenty-seven percent of eyes were within ±0.5 D of emmetropia and 32 percent were within ±1.0 D one year postoperatively.

    Complications were minimal and generally related to a pre-existing eye disease or a predisposing factor rather than the IOL implantation itself. Endothelial cell count decreased significantly. The main complications were cystoid macular edema (four eyes), pupillary block (two eyes) and transient IOP increase (three eyes).

    It appears that this procedure would be an acceptable alternative to anterior chamber IOLs or even sutured IOLs. Does this study motivate you to consider non-anterior chamber IOLs for secondary implants in certain patients? What patient factors may lead you to consider an iris-claw IOL versus an anterior chamber IOL or sutured IOL?