Iris-Claw Intraocular Lens Implantation in Pediatric Population: Indications, Outcomes, and a Comparison with Adult...

Objective: The utilization of iris-claw intraocular lens (IOL) in adult cases of capsular insufficiency has been investigated. However, the use of iris-claw IOL in the pediatric population is still under investigation. In this study, we evaluated the overall practice of iris-claw IOL implantation in pediatrics and compared the visual outcomes and postoperative complication rates between children and adults. Methods: Retrospectively, we examined the practice, indications, and outcomes of pediatric patients who underwent iris-claw "Artisan^®" intraocular lens implantation (IOL). All patients who underwent iris-claw IOL implantation for any causative indications were enrolled in the study. The outcome was compared by visual acuity and postoperative complications. Furthermore, the outcomes in pediatrics were compared to another adult group. Results: In this study, 41 eyes of 34 pediatric patients were included with a mean age of 11.1 years and a mean follow-up period of 24.5 months. Trauma is the most common indication for iris-claw IOL in pediatrics, followed by ectopia lentis and by congenital cataract. Iris-claw IOL was implanted anteriorly in 70.7% of pediatrics. Patients with retropupillary position achieved better visual outcome. Anterior iris-claw IOL had higher intraocular pressure readings and more decentration and disenclavation. In comparison with the adult group consisting of 130 eyes, pediatric iris-claw implantation was associated with more decentration and disenclavation, while adult practice was associated with more macular edema. Conclusions: Iris-claw IOL offers a relatively safe method for optical rehabilitation in pediatric patients where the capsular support is inadequate. Retropupillary implantation may achieve better visual outcome with less frequency of glaucoma and corneal endothelial loss.