IRIS-FIXATED WORST CLAW VERSUS SULCUS-FIXATED POSTERIOR CHAMBER LENSES IN THE ABSENCE OF CAPSULAR SUPPORT

Purpose: To evaluate visual outcomes and complications of iris-fixated intraocular lenses (IOLs) (lobster-claw) and sutured sulcus-fixated p osterior chamber (PC) IOLs in primary and secondary implantation. Sett ing: Eye Department, University Hospital ''La Fe'', Valencia, Spain. M ethods: This retrospective study reviewed 47 patients who had primary implantation of an iris-fixated (n=34) or sulcus-fixated (n=13) IOL an d 54 patients who had secondary implantation of an iris-fixated (n=41) or sulcus-fixated (n=13) IOL. Results: Visual acuity in the primary i mplantation group was similar with both lens types. Overall, 54.0% had a postoperative acuity of 20/40 or better. In eyes without pre-existi ng pathology, 60.0% with an iris-fixated IOL and 54.6% with a sutured PC IOL had this level of postoperative acuity (P=.768). In the seconda ry implantation group, the percentage of patients with a postoperative visual acuity of 20/40 or better was significantly higher in iris-fix ated IOL eyes (78.0%) than in sulcus-fixated PC IOL eyes (46.2%) (P <. 05). In eyes without pre-existing pathology, the difference was mainta ined. No intraoperative complications directly associated with iris-fi xated lens implantation occurred. The incidence of postoperative compl ications common to either IOL type in primary and secondary implantati on did not differ significantly. The incidence of retinal complication s was higher in eyes that had primary implantation of either lens type , although the differences between both lenses in either primary or se condary implantation were not significant. Conclusion: The good visual outcomes and low incidence of intraoperative and postoperative compli cations in eyes with iris-fixated IOLs indicate that these lenses shou ld be considered an alternative to sutured PC IOLs in eyes in which ca psular support is inadequate or absent.