Morphologic alterations on posterior iris-claw intraocular lenses after traumatic disenclavation

To analyse morphologic alterations on posterior iris-claw intraocular lenses (IOL) after dislocation due to traumatic disenclavation.

Seven dislocated iris-claw IOLs were included in this observational study. Five posterior iris-claw IOLs were explanted after traumatic disenclavation and compared to two iris-claw IOLs with a history of spontaneous disenclavation. One original aphakic iris-claw IOL served as control. All IOLs underwent standardised examinations using light microscopy.

All traumatically disenclaved iris-claw haptics presented decentred and twisted fixation arms. The average decentration on iris-claw haptics measured 23±11 µm in the surface plane and 103±43 µm on the edge profile; the axial twist of the fixation arms measured five angular degrees. Traumatically affected haptics were tilted (3/5) or did not provide an adequate closure (2/5), so that a reliable fixation on the iris stroma was not ensured. Morphologic alterations were significantly different after traumatic and spontaneous disenclavation. Spontaneously disenclaved IOLs and the original IOL demonstrated symmetric haptics with centred iris-claws and a sufficient closure.

Traumatically dislocated iris-claw IOLs presented considerable alterations on the affected haptics, which might not guarantee a reliable re-enclavation. Therefore, we suggest an IOL replacement, instead of reenclavation, in cases of traumatic iris-claw disenclavation.