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Alice Hong, Jocelyn Kuryan, Elaine Wu, David Ritterband, John Seedor; Clinical Outcomes and Complications of Iris Sutured Posterior Chamber Intraocular Lens Implants. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2992.
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To report the predisposing risk factors, visual outcomes and intra-operative and post-operative complications of patients that received iris sutured posterior chamber intraocular lenses (IOLs) in eyes due to inadequate capsular support.
Retrospective chart review and data analysis were completed of all patients that underwent iris fixation of three piece foldable acrylic IOL for correction of aphakia in the absence of caspular support. All surgeries were performed by the same team of surgeons. Data included clinical risk factors, pre-operative and post-operative vision, surgical history, concomitant procedures, intra-operative and post-operative complications including elevated intraocular pressure (IOP), corneal edema, IOL dislocation, hyphema, macular edema, vitreous hemorrhage and retinal detachment.
The medical records of all eyes that underwent iris sutured posterior chamber IOL placement from 2003 to 2010 were reviewed. 132 cases of iris sutured posterior chamber IOLs were analyzed. Mean age was 69.4 years old. Length of follow-up ranged from 1 month to 5 years with a mean follow-up of 24 months. The most common predisposing risk factors necessitating an iris fixated IOL were trauma 19.6% (26/132), pseudoexfoliation 12.8% (17/132) and ectopia lentis 3% (4/132). 85.6% (113/132) had prior intraocular surgery;14.3% (19/132) had prior pars plana vitrectomy (PPV) and 6% (8/132) had prior penetrating keratoplasty (PK). 43.9% (58/132) underwent concurrent PPV and 15.1% (20/132) had combined PK surgery. Best corrected visual acuity ranged from 20/20 to light perception. 90.1% (119/132) had a significant improvement from pre-operative visual acuity. The most common post-operative complications included elevated IOP in 19.6% (26/132), IOL dislocation in 18.9% (25/132), irregular pupil 8.3% (11/132), corneal edema requiring DSAEK 7.5% (10/132), vitreous hemorrhage 6.8%(9/132), hyphema 5.3% (7/132), macular edema 2.2% (3/132) and retinal detachment 1.5% (2/132).
Iris fixated posterior chamber IOLs can be an excellent option for rehabilitation of eyes that do not have adequate capsular support for posterior chamber IOLs. Most patients had significant improvement of their best corrected visual acuity with few complications and good long term stability.
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