Outcomes of posterior chamber iris-claw intraocular lenses implantation in aphakic eyes with insufficient capsular support: retrospective observational study Original research study

Main Article Content

Ilona Kaczmarek
Jaromir Wasyluk
Ilona Jędrzejewska
Małgorzata Myślińska
Marek E. Prost


Background: Implantation of posterior chamber iris-claw intraocular lenses (IOLs) is often used in the surgical management of aphakia with inadequate capsular support. The purpose of the study was to evaluate the anatomical and functional outcomes and complication rate after implantation of a posterior chamber irisclaw aphakic IOL in eyes with insufficient capsular support.
Methods: This retrospective observational study comprised patients without adequate capsular support undergoing posterior iris-claw aphakic IOL implantation between 2016 and 2018.
Results: The study comprised 44 eyes of 44 patients. The mean follow-up was 12 months (range from 1 to 24 months). The IOLs were inserted during primary lens surgery in five eyes (11.36%), during a posterior chamber IOL exchange procedure in 24 eyes (54.55%), and as a secondary procedure in 15 aphakic eyes (34.09%). The final mean best corrected visual acuity (BCVA) was significantly better than preoperatively (0.49 ± 0.33 vs 0.36 ± 0.26, Snellen decimals) (P < 0.05). The most common complication after surgery was transient elevated intraocular pressure (10 eyes; 22.73%).
Conclusions: The posterior chamber iris-claw aphakic IOLs provided good anatomical and functional outcomes and can be used for a wide range of indications in eyes without adequate capsular support.

Article Details

How to Cite
Kaczmarek I, Wasyluk J, Jędrzejewska I, Myślińska M, Prost ME. Outcomes of posterior chamber iris-claw intraocular lenses implantation in aphakic eyes with insufficient capsular support: retrospective observational study. Ophthatherapy [Internet]. 2020Mar.31 [cited 2020Jun.1];7(1):51-8. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/977
Surgery and laser therapy


1. Worst JG, Massaro RG, Ludwig HH. The introduction of an artificial lens into the eye using Binkhorst’s technique. Ophthalmologica. 1972; 164(5): 387-91.
2. Jezierski M, Kaczmarek I, Prost ME. Zastosowanie implantów soczewek wewnątrzgałkowych typu iris-claw u pacjentów z bezsoczewkowością. OphthaTherapy. 2014; 4(4): 1-5.
3. Toro MD, Longo A, Avitabile T et al. Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation. PLoS ONE 2019; 14(4): e0214140.
4. Stem MS, Todorich B, Woodward MA et al. Scleral-Fixated Intraocular Lenses: Past and Present. J Vitreoretin Dis. 2017; 1(2): 144-52.
5. Walia S, Kashyap S, Bhaisare V et al. Novel technique of sutureless glueless scleral fixated intraocular lens (SFIOL). Indian J Ophthalmol. 2019; 67(1): 64-8.
6. Can E. Flapless and sutureless intrascleral fixation of posterior chamber intraocular lens for correction of aphakia. J Cataract Refract Surg. 2018; 44(8): 929-31.
7. Dinc E, Vatansever M, Dursun Ö et al. Scleral fixated intraocular lens implantation with a modified Z-suture technique. Int Ophthalmol. 2018; 38(6): 2357-61.
8. Saleh M, Heitz A, Bourcier T et al. Sutureless intrascleral intraocular lens implantation after ocular trauma. J Cataract Refract Surg. 2013; 39(1): 81-6.
9. Wallmann AC, Monson BK, Adelberg DA. Transscleral fixation of a foldable posterior chamber intraocular lens. J Cart Refract Surg. 2015; 41(9): 1804-9.
10. Obeng FK, Vig VK, Singh P et al. Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes. J Clin Diagn Res. 2017; 11(3): NC09-13.
11. Yang C, Chao Y. Long-term outcome of combined vitrectomy and transscleral suture fixation of posterior chamber intraocular lenses in the management of posteriorly dislocated lenses. J Chin Med Assoc. 2016; 79(8): 450-5.
12. Jayamadhury G, Potti S, Kumar KV et al. Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes. Indian J Ophthalmol. Indian J Ophthalmol. 2016; 64(10): 743-6.
13. De Silva SR, Arun K, Anandan M et al. Iris-claw intraocular lenses to correct aphakia in the absence of capsule support. J Cataract Refract Surg. 2011; 37(9): 1667-72.
14. Rüfer F, Saeger M, Nölle B et al. Implantation of retropupillar iris claw lenses with and without combined penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol. 2009; 247(4): 457-62.
15. Schallenberg M, Dekowski D, Hahn A et al. Aphakia correction with retropupillary fixated iris-claw lens (Artisan) – long-term results. Clin Ophthalmol. 2014; 8: 137-41.
16. Mohr A, Hengerer F, Eckardt C. Retropupillary fixation of the iris claw lens in aphakia. 1 year outcome of a new implantation techniques. Ophthalmologe. 2002; 99(7): 580-3.
17. Jing W, Guanlu L, Qianyin Z et al. Iris-Claw Intraocular Lens and Scleral-Fixated Posterior Chamber Intraocular Lens Implantations in Correcting Aphakia: A Meta-Analysis. Invest Ophthalmol Vis Sci. 2017; 58(9): 3530-6.
18. Teng H, Zhang H. Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes. Int J Ophthalmol. 2014; 7(2): 283-7.
19. Hara S, Borkenstein AF, Ehmer A et al. Retropupillary fixation of iris-claw intraocular lens versus transscleral suturing fixation for aphakic eyes without capsular support. J Refract Surg. 2011; 27(10): 729-35.
20. Gonnermann J, Klamann MK, Maier AK et al. Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation. J Cataract Refract Surg. 2012; 38(12): 2139-43.
21. Baykara M, Ozcetin H, Yilmaz S et al. Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am J Ophthalmol. 2007; 144(4): 586-91.
22. Gicquel JJ, Guigou S, Bejjani RA et al. Ultrasound biomicroscopy study of the Verisyse aphakic intraocular lens combined with penetrating keratoplasty in pseudophakic bullous keratopathy. J Cataract Refract Surg. 2007; 33(3): 455-64.
23. Mora P, Calzetti G, Favilla S et al. Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation. J Ophthalmol. 2018; 2018: 8463569.
24. Schmidt I, Langenbucher A, Moussa S et al. Retroiridale Implantation einer VerisyseTM IrisklauenlinseRetroiridal implantation of a VerisyseTM iris claw lens. Der Ophthalmol. 2014; 112(3): 261-5.
25. Gonnermann J, Amiri S, Klamann M et al. Endothelial cell loss after retropupillary iris-claw intraocular lens implantation. Klin Monbl Augenheilkd. 2014; 231(8): 784-7.
26. Wolter-Roessler M, Küchle M. Correction of aphakia with retroiridally fixated IOL. Klin Monbl Augenheilkd. 2008; 225(12): 1041-4.
27. Forlini M, Soliman W, Bratu A et al. Long-term follow-up of retropupillary iris-claw Intraocular lens implantation: a retrospective analysis. BMC Ophthalmol. 2015; 15: 143.
28. Dick HB, Budo C, Malecaze F et al. Foldable Artiflex phakic intraocular lens for the correction of myopia: two-year follow-up results of a prospective European multicenter study. Ophthalmology. 2009; 116(4): 671-7.
29. Jayamadhury G, Potti S, Kumar KV et al. Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes. Indian J Ophthalmol. 2016; 64(10): 743-6.

Most read articles by the same author(s)