Retropupillary iris-claw intraocular lens and pars plana vitrectomy in aphakia management

Background: The surgical case of a dropped intraocular lens inside the vitreous cavity constitutes a real challenge for the operating surgeon. Herein, we describe a case series where an alternative optical rehabilitation technique for late intraocular lens-bag complex dislocation has been used. Methods: A modern vitrectomy device was used to remove the capsule with the dropped intraocular lens using sutureless 25-gauge pars plana vitrectomy. To ensure a better aesthetic result, with faster patient recovery and a reduced number of operations, the whole procedure was performed during the same operating session; an iris-claw intraocular lens for aphakia was selected for implantation. The implant was passed behind the constricted iris with the concave surface facing it. The lens was grasped with the manufacturer’s holding forceps and fixed onto the posterior surface of the iris using the special enclavation needles. Results: We have operated 12 eyes in two different clinical centres successfully, with minimal intra- and/or postoperative complications. Conclusion: We believe that this is a viable solution for the visual rehabilitation of patients, who would otherwise need more than one operation for a lens exchange.

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SECONDARY IRIS CLAW INTRAOCULAR LENS IMPLANTATION FOR THE CORRECTION OF APHAKIA AFTER PARS PLANA VITRECTOMY

Retina ◽

10.1097/iae.0b013e3181b32eef ◽

2010 ◽

Vol 30 (1) ◽

pp. 131-139 ◽

Cited By ~ 18

Author(s):

NUR ACAR ◽

ZIYA KAPRAN ◽

TUGRUL ALTAN ◽

YASAR KUCUKSUMER ◽

YAPRAK BANU UNVER ◽

...

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Intraocular Lens Implantation ◽

Lens Implantation ◽

Pars Plana ◽

Iris Claw

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Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Scientific Reports ◽

10.1038/s41598-020-80292-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eun Young Choi ◽

Chul Hee Lee ◽

Hyun Goo Kang ◽

Jae Yong Han ◽

Suk Ho Byeon ◽

...

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Case Series ◽

Retrospective Case ◽

Iol Implantation ◽

Intraocular Lens Dislocation ◽

Post Surgery ◽

Pars Plana ◽

Iol Dislocation ◽

Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

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Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens

Indian Journal of Ophthalmology ◽

10.4103/0301-4738.86321 ◽

2011 ◽

Vol 59 (6) ◽

pp. 497 ◽

Cited By ~ 3

Author(s):

KishorB Patil ◽

MPrabhu Shanker ◽

Padmanabhan Meleth

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Pars Plana ◽

Iris Claw

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Pars plana vitrectomy combined with iris-claw intraocular lens implantation for lens nucleus and intraocular lens dislocation

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2013.12.025 ◽

2014 ◽

Vol 40 (9) ◽

pp. 1488-1497 ◽

Cited By ~ 8

Author(s):

Elodie Labeille ◽

Carole Burillon ◽

Pierre-Loïc Cornut

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Intraocular Lens Implantation ◽

Lens Dislocation ◽

Intraocular Lens Dislocation ◽

Lens Implantation ◽

Pars Plana ◽

Iris Claw

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Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094545 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4545

Author(s):

Tomasz K. Wilczyński ◽

Alfred Niewiem ◽

Rafał Leszczyński ◽

Katarzyna Michalska-Małecka

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Vision Loss ◽

Silicone Oil ◽

Single Case ◽

Recurrent Dislocation ◽

Ectopia Lentis ◽

Pars Plana ◽

The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

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