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Secondary iris-claw anterior chamber lens implantation in patients with aphakia without capsular support
  1. Jose L Güell1,2,
  2. Paula Verdaguer1,2,
  3. Daniel Elies1,
  4. Oscar Gris1,
  5. Felicidad Manero1,
  6. Gloria Mateu-Figueras3,
  7. Merce Morral1,4
  1. 1Department of Cornea and Refractive Surgery, Instituto Microcirugia Ocular, Barcelona, Spain
  2. 2Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
  3. 3Department of Mathematics at the Universitat de Girona, Girona, Spain
  4. 4Department of Cornea and Anterior Segment Diseases and Department of Refractive Surgery of the Institut Clinic d'Oftalmologia, Hospital Clinic i Provincial, Barcelona, Spain
  1. Correspondence to Dr Paula Verdaguer, Instituto de Microcirugia Ocular (IMO), c/Josep Maria Llado 3, Barcelona 08035, Spain; paulaverdaguer{at}


Background/aims To evaluate the efficacy, predictability, safety and complications of secondary iris-claw intraocular lens (IOL) implantation in aphakic eyes without capsular support.

Methods Retrospective, non-comparative, interventional case series of 128 aphakic eyes, which consecutively underwent secondary iris-claw Artisan IOL (Ophtec BV) implantation, were included. Manifest refraction, uncorrected visual acuity, best-spectacle corrected visual acuity, biomicroscopy, tonometry, funduscopy and central endothelial cell count (cECC) were evaluated before surgery, and at yearly intervals up to 5 years. Minimum follow-up time was 1 year.

Results One hundred twenty-eight eyes were treated. Mean age was 54.55 years (range, 1–98 years). Mean follow-up was 41.8 months (SD 23.63). Mean preoperative logarithm of the minimum angle of resolution BSCVA and spherical equivalent (SE) were 0.67 ((SD) 0.53) and 9.63 D (SD 5.50), respectively. One year postoperatively, mean logarithm of the minimum angle of resolution best-spectacle corrected visual acuity improved to 0.52 (SD 0.46) (p<0.05), and remained stable up to 5 years. One year postoperatively, mean SE was −0.52 (SD 2.21) (p<0.05). Mean SE progressively decreased during the 1st year, and remained stable thereafter (p<0.05). Mean preoperative cECC was 2237.47 (SD 793.33) cells/mm2. cECC showed a slight, though statistically significant, decrease over the years (p=0.05). Main complications were: 2 pupillary block; 3 transient increase in intraocular pressure; 1 IOL replacement; 2 penetrating keratoplasty and 4 cystoid macular oedema.

Conclusions Iris-claw IOL implantation in aphakic eyes is an effective, predictable and safe procedure in the first 5 years of follow-up. However, a longer follow-up is required to demonstrate its long-term safety.

  • Anterior chamber
  • Cornea
  • Lens and zonules
  • Optics and Refraction
  • Treatment Surgery

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