Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty

  • Johannes Gonnermann
  • Necip Torun
  • Matthias K. J. Klamann
  • Anna-Karina B. Maier
  • Christoph v. Sonnleithner
  • Antonia M. Joussen
  • Peter W. Rieck
  • Eckart Bertelmann



To evaluate the indication, visual outcome, and complication rate after implantation of a posterior iris-claw aphakic intraocular lens (IOL) during penetrating keratoplasty.


This retrospective study comprised 23 eyes (23 patients) without adequate capsule support undergoing posterior iris-claw aphakic IOL implantation (Verisyse™/Artisan®) during penetrating keratoplasty between 2005 and 2010. Mean follow-up was 18 months (range from 12 to 37 months).


The IOLs were inserted during an IOL exchange in 17 eyes and as a secondary procedure in six aphakic eyes. Pseudophakic bullous keratopathy with corneal scar after anterior chamber intraocular lens (ACIOL) was the main indication for penetrating keratoplasty in 16 eyes (69.6 %). The final corrected distance visual acuity (CDVA) in logMAR (mean 1.0 ± 0.46) improved significantly (p < 0.05) compared to the preoperative CDVA (mean 1.8 ± 0.73). Twenty eyes (86.9 %) had a final visual acuity in logMAR better than the pre-operative CDVA. The mean postoperative IOP 16.3 mmHg ± 4.0 was not significantly (p > 0.05) higher compared to the preoperative IOP 15.6 mmHg ± 5.1. Complications included slight temporary pupil ovalization in three eyes (13.0 %) and iris-claw IOL sublocation in three eyes (13.0 %); all IOLs could be easily repositioned. Cystoid macular edema occured in one eye (4.3 %) 8 weeks after primary surgery. All grafts remained clear without any sign of graft rejection.


Retropupillar iris-claw IOL during penetrating keratoplasty provides good visual outcomes with a favorable complication rate, and can be used for a wide range of indications in eyes without adequate capsule support.


Aphakia Bullous keratopathy Penetrating keratoplasty Iris-claw Retropupillar Verisyse Artisan 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Johannes Gonnermann
    • 1
  • Necip Torun
    • 1
  • Matthias K. J. Klamann
    • 1
  • Anna-Karina B. Maier
    • 1
  • Christoph v. Sonnleithner
    • 1
  • Antonia M. Joussen
    • 1
  • Peter W. Rieck
    • 1
  • Eckart Bertelmann
    • 1
  1. 1.Department of OphthalmologyCharité, University Medicine BerlinBerlinGermany

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