September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Long term visual outcome, complication and postural myopic shift assessment after posterior iris-claw aphakic intraocular lens implantation.
Author Affiliations & Notes
  • Pierre Queromes
    Ophthalmology, Foch Hospital, Suresnes, France
  • Matthieu Randon
    Ophthalmology, Foch Hospital, Suresnes, France
    CHNO, Paris, France
  • Lara Azzarone
    Ophthalmology, Foch Hospital, Suresnes, France
  • Vincent Pierre-Kahn
    Ophthalmology, Foch Hospital, Suresnes, France
  • Footnotes
    Commercial Relationships   Pierre Queromes, None; Matthieu Randon, None; Lara Azzarone, None; Vincent Pierre-Kahn, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1310. doi:
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      Pierre Queromes, Matthieu Randon, Lara Azzarone, Vincent Pierre-Kahn; Long term visual outcome, complication and postural myopic shift assessment after posterior iris-claw aphakic intraocular lens implantation.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1310.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Posterior chamber iris-claw intraocular lens (IOL) is often used in aphakic eyes with inadequate capsular support. Postoperatively, patients my describe better capabilities for near reading in a face-down position.
Objective: To evaluate the indications, visual outcomes and complication rate of this IOL. To compare postoperative spherical equivalent between the prone and the face-down position.

Methods : Retrospective single-center case series of 50 patients operated between 2007 and 2014. Visual outcome, early and late complications were analyzed. The refractive measurements were also assessed using a portable refractometer device in a prone and a face-down position for each patient. The spherical equivalents were then compared.

Results : Fifty-two eyes were studied. The mean follow up was 45 months (13-96). The IOLs were inserted during a secondary procedure in all cases (dislocated lens or IOL, aphakic eyes). The final mean corrected visual acuity (0.36 +-0,35 SD LogMar) was significantly better than preoperatively (0,67 +-0,49 SD LogMar) (p< 0,05). Postoperative errors were within +-2 diopters of emmetropia in 95% of patients. The average spherical equivalent in prone and face down position were different (p<0.05), respectively -0.81 diopters (-4; +2.75; sd:1,9) and -1.78 diopters (-5.25; 1; sd: 2,2). An average myopic shift of -0.97 diopters (-2.88; 0.25; sd: 1,1) was observed in face down postion. Cystoïde macular oedema (6%) and IOL disenclavation (4%) were the main complications.

Conclusions : Posterior iris-claw intraocular lens appears to be an effective and relatively safe IOL to treat aphakia with poor capsular support. When the patient’s head is bent forward, a mean myopic shift of 1 diopter is observed. This may support the idea that this IOL could be considered as an accommodative implant. An iris-IOL anterior move due to gravity may be responsible for this myopic shift. An ultra sound bio microscopy study may confirm this anatomical anterior mobility.
The retro-pupillary iris-claw IOL provide good and predictable functional outcome with few ocular complications. A postural accommodative capacity is proven in head bent forward position.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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