Endothelial cell loss after retropupillary iris-claw intraocular lens implantation

• Published in: Klinische Monatsblatter fur Augenheilkunde Vol. 231; no. 8; p. 784
• Main Authors: Gonnermann, J, Amiri, S, Klamann, M, Maier, A-K B, Joussen, A M, Rieck, P W, Torun, N, Bertelmann, E
• Format: Journal Article
• Language: German
• Published: Germany 01.08.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Aphakia, Postcataract - diagnosis; Aphakia, Postcataract - etiology; Aphakia, Postcataract - surgery; Cell Count; Corneal Endothelial Cell Loss - diagnosis; Corneal Endothelial Cell Loss - etiology; Endothelium, Corneal - pathology; Female; Humans; Lens Implantation, Intraocular - adverse effects; Lenses, Intraocular - adverse effects; Male; Middle Aged; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Prosthesis Design; Refraction, Ocular; Retrospective Studies; Visual Acuity; Young Adult
• ISSN: 1439-3999
• DOI: 10.1055/s-0034-1368453

The aim of this study was to evaluate the indication, visual and refractive outcome, endothelial cell loss and complication rate after implantation of a posterior iris-claw aphakic intraocular lens (IOL). This retrospective study comprised 62 eyes of 56 patients without adequate capsular support undergoing posterior iris-claw aphakic IOL implantation (Verisyse™/Artisan®) between 2006 and 2012. Mean follow-up was 34 months (range from 13 to 78 months). The IOLs were inserted during primary lens surgery in 11 phakic eyes (17.8 %), during an IOL exchange procedure for dislocated posterior chamber IOLs in 34 eyes (54.8 %), and as a secondary procedure in 17 aphakic eyes (27.4 %). The final best spectacle-corrected visual acuity (BSCVA) in logMAR (mean 0.24 ± 0.45) improved significantly (p < 0.001) compared to the preoperative BSCVA (mean 0.61 ± 0.65). The mean spherical equivalent improved from preoperative 7,25 ± 5,04 diopters (D) (range - 10.25 to + 16.0 D) to - 0.21 ± 1.01 D (range - 4.0 to 3.0 D) postoperatively. Mean central endothelial cell density was 1844 ± 690 cells/mm(2) preoperatively. After surgery mean endothelial cell density decreased statistically not significant with a loss of 5.5 % to 1743 ± 721 cells/mm(2) (p > 0.05) at last follow-up visit. Complications included cystoid macular oedema in 4 eyes (6.4 %), early postoperative hypotony in 2 eyes (3.2 %), pupil ovalisation in 2 eyes (3.2 %), traumatic iris-claw IOL disenclavation in 2 eyes (3.2 %) and spontaneous IOL disenclavation in one eye (1.6 %). Retropupillar iris-claw IOL provides good visual and refractive outcomes with a low endothelial cell loss and can be used for a wide range of indications in eyes without adequate capsular support.