[Retroiridal iris claw lens as routine procedure]

Area of Science:

• Ophthalmology
• Intraocular Lens Implantation
• Cataract Surgery

Background:

• Absence of capsular support or extended zonulolysis necessitates retroiridal enclavation of iris claw intraocular lenses (IOLs) when sufficient iris support is present.
• Contraindications for this procedure include uveitis and ischaemic retinopathies.
• The retroiridal iris claw lens (Verisyse®/Artisan®) is indicated for 'in-the-bag' IOL dislocation due to pseudoexfoliation (PEX) zonulopathy and complicated phacoemulsification with large zonular defects.

Purpose of the Study:

• To evaluate the efficacy and safety of retroiridal iris claw lens implantation in complex cataract cases.
• To assess refractive outcomes and optical quality compared to endocapsular fixation.
• To determine the complication rates associated with this surgical technique.

Main Methods:

• Retrospective analysis of 81 eyes implanted with retroiridal iris claw lenses.
• Laser optic biometry was used for refractive targeting.
• Wavefront analysis was performed to assess optical quality.

Main Results:

• 100% of 'in-the-bag' luxation cases achieved target refraction within 1 D; 62% of more complicated cases did.
• No significant difference in optical quality was observed between retroiridal iris claw lenses and endocapsular spherical IOLs.
• Iris pigment atrophy was clinically insignificant, and the risk of cystoid macular edema was lower than with sclera-suture-fixated lenses.

Conclusions:

• Retroiridal iris claw lenses can be implanted atraumatically under topical anesthesia.
• Intraocular lens-related complications are minimal.
• This technique provides a valuable option for complex cataract surgeries where standard IOL fixation is not feasible.