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Scleral Fixation of Intraocular Lens and Retropupillary Fixation of Iris Claw Lens for Aphakic Eyes
무수정체안에서 인공수정체공막고정술 및 홍채 후방고정 안내렌즈삽입술 비교
JKOS 2019 Jul;60(7):643-53
Published online July 15, 2019;  https://doi.org/10.3341/jkos.2019.60.7.643
Copyright © 2019 The Korean Ophthalmological Society.
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Joo Young Kim, MD, Chang Hyun Park, MD, Woong Joo Whang, MD, PhD, Kyung Sun Na, MD, PhD, Hyun Seung Kim, MD, PhD
김주영⋅박창현⋅황웅주⋅나경선⋅김현승

Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
가톨릭대학교 의과대학 여의도성모병원 안과
Received February 14, 2019; Revised March 10, 2019; Accepted June 25, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: To compare the efficacy and complications of scleral fixation of posterior chamber intraocular lens (IOL) and retropupillary fixation of iris claw IOL for dislocated IOL or aphakia without sufficient capsular support.
Methods: This retrospective study was comprised of 17 eyes of 16 patients undergoing scleral fixation and 14 eyes of 13 patients undergoing retropupillary fixation from August 2013 to June 2018. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp examination, corneal topography, refractive indices, corneal curvatures, corneal endothelial cell density, and complications of both groups were examined preoperatively and 1 day, 1 week, 1 month, 2 months, and 6 months postoperatively.
Results: Six months after the operation, UCVA and BCVA improved in both groups; however, there were no significant differences between the two groups (UCVA, p = 0.162; BCVA, p = 0.418). IOP was temporarily higher in the scleral fixation group at one day postoperatively (p = 0.023). The mean absolute prediction error was smaller in the retropupillary iris fixation group at 6 months postoperatively (p = 0.034). Postoperative total astigmatism, corneal astigmatism, and corneal endothelial cell density were not significantly different between the two groups.
Conclusions: The retropupillary iris fixation group did not show significant improvement in visual acuity compared with the scleral fixation group. However, the retropupillary iris fixation group provided better mean absolute prediction error and a low risk of postoperative increase in IOP compared with the scleral fixation group. Retropupillary fixation of iris claw IOL is a promising option for scleral fixation of posterior chamber IOL for dislocated IOL or aphakia without sufficient capsular support.
Keywords : Aphakic eye, Dislocated intraocular lens, Retropupillary fixation, Scleral fixation

 

November 2019, 60 (11)