Iris-claw intraocular lens implantation: Efficiency and safety according to technique

Purpose: To evaluate the safety, refractive and visual results of an iris-claw intraocular lens for aphakia (Artisan) according to the technique used. Setting: Ophthalmology Department, Valme University Hospital and Oftalvist Clinic, Seville, Spain. Design: Retrospective case series. Methods: This study evaluated the outcomes of iris-claw IOL implantations performed by the same surgeon between 2011 and 2017. The results were analyzed by the incision type (corneal versus scleral tunnel) and lens position (prepupillary versus retropupillary). Results: Seventy-six eyes (75 patients) were included. The postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuities were significantly better than the preoperative acuities (P < .001). The UDVA was 20/40 or better in 41.7% of patients, and had the CDVA was 20/40 or better in 68.1% of patients. The mean UDVA was significantly better in the scleral tunnel incision group (0.29 logarithm of the minimum angle of resolution [logMAR] +/- 0.41 [SD]) than in the corneal incision group (0.66 +/- 0.45 logMAR) (P < .001). The mean surgically induced astigmatism in the scleral tunnel incision group (0.73 +/- 0.62 diopter [D]) was significantly lower than in the corneal incision group (2.49 +/- 1.36 D) (P < .001). Although endothelial cell loss was lower in the retropupillary position, the difference was not significant (P = .07.) Conclusion: Implantation of the iris-claw IOL in the retropupillary position and through a scleral tunnel incision was an effective and safe alternative to aphakia without capsule support, providing better refractive results compared with other techniques. (C) 2018 ASCRS and ESCRS