Study: Iris-fixated lens an option for aphakic correction in complicated cases

PARIS — Implantation of an iris-fixated IOL can be an effective alternative to suture-fixated posterior capsular IOLs for correcting aphakia in patients with compromised capsular support, according to a study presented here.

Sonia Campos, MD, and colleagues studied 74 eyes of 73 consecutive patients in which an iris-fixated lens was implanted after complicated cataract surgery. Patients’ mean age was 73. Average follow-up was 12 months. The results were presented in a poster at the European Society of Cataract and Refractive Surgeons meeting.

Complications included vitreous lens luxation, lens subluxation, ectopia lentis in Marfan's syndrome, trauma, and weak, loose or partially broken zonules due to pseudoexfoliation syndrome and extensive posterior capsular rupture.

Implantation of the Ophtec Artisan IOL was performed at the primary surgery in 5.4% of cases and in a secondary procedure in 94.6% of cases, according to the study authors.

Patients with other ocular diseases, such as glaucoma, chronic uveitis or retinal disease were excluded from the study, as well as patients with best corrected visual acuity less than 0.3, patients with anterior chamber depths less than 3.3 mm and patients with endothelial cell counts less than 2,000 cells/mm².

Postoperatively, best corrected visual acuity improved to 0.46 from a preoperative mean of 0.21, the authors noted. At the final follow-up visit, 57.8% of patients achieved a BCVA of at least 0.4.

There was one case of anterior uveitis and one case of retinal detachment with no foveal involvement, which was treated with vitrectomy. No patients experienced significant endothelial cell loss, and there was no significant IOL decentration, the study authors noted.