International Ophthalmology

, Volume 38, Issue 5, pp 1985–1992 | Cite as

Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations

  • Anju RastogiEmail author
  • Apurva GorayEmail author
  • Prolima Thacker
  • Kamlesh
  • Babita
Original Paper



To evaluate whether retropupillary fixation of the iris-claw intraocular lens (IOL) is a safe and effective treatment option in children with large lens subluxations.


Fourteen eyes of children between the ages of 8–17 years with lens subluxations more than 7 clock hours underwent pars plana lensectomy-vitrectomy with implantation of the iris-claw IOL in the retropupillary position as a primary procedure. The best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial count (EC) and the lens position using ultrasound biomicroscopy (UBM) were assessed pre- and postoperatively.


Postoperatively, all patients had an increase in the BCVA with a mean of 0.351 ± 0.154 log MAR units which was statistically significant as compared to the preoperative value of 0.771 ± 0.132 log MAR units (p = 0.003). The difference between the mean preoperative IOP (13.642 ± 2.437 mmHg) and the mean postoperative intraocular pressure at the end of 6 months (13.5 ± 2.244 mmHg) was not statistically significant (p = 0.671). The mean EC decreased by 0.99% from 2838.42 ± 474.76 cells/mm2 preoperatively to 2810 ± 461.24 cells/mm2 at the end of 6 months postoperatively (p = 0.117). The lens position was analyzed using UBM and was found to be parallel to the iris plane in all cases at the end of 6 months.


Our study shows that primary retropupillary iris-claw IOL implantation can be a safe and efficacious option for children with large (>7 clock hours) lens subluxations that is at least comparable to scleral-fixated PCIOLs.


Retropupillary IOL Subluxated lens Children 



No special source of funding has been received for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

It has been taken in all cases from the patients and their parents/legal guardians.


  1. 1.
    McCluskey P, Harrisberg B (1994) Long-term results using scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg 20(1):34–39CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Dick HB, Augustin AJ (2001) Lens implant selection with absence of capsular support. Curr Opin Ophthalmol 12(1):47–57CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Kumar M, Arora R, Sanga L, Sota LD (1999) Scleral-fixated intraocular lens implantation in unilateral aphakic children. Ophthalmology 106(11):2184–2189CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Por YM, Lavin MJ (2005) Techniques of intraocular lens suspension in the absence of capsular/zonular support. Surv Ophthalmol 50(5):429–462CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Hara S, Borkenstein AFM, Ehmer A, Auffarth GU (2011) Retropupillary fixation of iris-claw intraocular lens versus transscleral suturing fixation for aphakic eyes without capsular support. J Refract Surg Thorofare NJ 1995 27(10):729–735Google Scholar
  6. 6.
    Agarwal A, Kumar DA, Jacob S, Baid C, Agarwal A, Srinivasan S (2008) Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules. J Cataract Refract Surg 34(9):1433–1438CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Price FW, Dobbins K, Zeh W (2002) Penetration of topically administered ofloxacin and trimethoprim into aqueous humor. J Ocul Pharmacol Ther Off J Assoc Ocul Pharmacol Ther 18(5):445–453CrossRefGoogle Scholar
  8. 8.
    Downing JE (1992) Ten-year follow up comparing anterior and posterior chamber intraocular lens implants. Ophthalmic Surg 23(5):308–315PubMedPubMedCentralGoogle Scholar
  9. 9.
    Evereklioglu C, Er H, Bekir NA, Borazan M, Zorlu F (2003) Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg 29(2):301–308CrossRefPubMedCentralGoogle Scholar
  10. 10.
    Hara T, Hara T (2004) Ten-year results of anterior chamber fixation of the posterior chamber intraocular lens. Arch Ophthalmol Chic Ill 1960 122(8):1112–1116CrossRefGoogle Scholar
  11. 11.
    Pyeritz RE, McKusick VA (1979) The Marfan syndrome: diagnosis and management. N Engl J Med 300(14):772–777CrossRefPubMedCentralGoogle Scholar
  12. 12.
    Baykara M, Ozcetin H, Yilmaz S, Timuçin OB (2007) Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am J Ophthalmol 144(4):586–591CrossRefPubMedCentralGoogle Scholar
  13. 13.
    Wagoner MD, Cox TA, Ariyasu RG, Jacobs DS, Karp CL (2003) American Academy of Ophthalmology. Intraocular lens implantation in the absence of capsular support: a report by the American Academy of Ophthalmology. Ophthalmology 110(4):840–859CrossRefPubMedCentralGoogle Scholar
  14. 14.
    Hsing YE, Lee GA (2012) Retropupillary iris claw intraocular lens for aphakia. Clin Exp Ophthalmol 40(9):849–854CrossRefPubMedCentralGoogle Scholar
  15. 15.
    Gonnermann J, Klamann MKJ, Maier A-K, Rjasanow J, Joussen AM, Bertelmann E et al (2012) Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation. J Cataract Refract Surg 38(12):2139–2143CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Mohr A, Hengerer F, Eckardt C (2002) Retropupillary fixation of the iris claw lens in aphakia. 1 year outcome of a new implantation techniques. Ophthalmol Z Dtsch Ophthalmol Ges 99(7):580–583Google Scholar
  17. 17.
    Güell JL, Velasco F, Malecaze F, Vázquez M, Gris O, Manero F (2005) Secondary Artisan-Verysise aphakic lens implantation. J Cataract Refract Surg 31(12):2266–2271CrossRefPubMedCentralGoogle Scholar
  18. 18.
    Menezo JL, Cisneros AL, Rodriguez-Salvador V (1998) Endothelial study of iris-claw phakic lens: four year follow-up. J Cataract Refract Surg 24(8):1039–1049CrossRefPubMedCentralGoogle Scholar
  19. 19.
    Anbari A, Lake DB (2015) Posteriorly enclavated iris claw intraocular lens for aphakia: long-term corneal endothelial safety study. Eur J Ophthalmol 25(3):208–213CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Solomon K, Gussler JR, Gussler C, Van Meter WS (1993) Incidence and management of complications of transsclerally sutured posterior chamber lenses. J Cataract Refract Surg 19(4):488–493CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Gicquel J-J, Guigou S, Bejjani RA, Briat B, Ellies P, Dighiero P (2007) Ultrasound biomicroscopy study of the Verisyse aphakic intraocular lens combined with penetrating keratoplasty in pseudophakic bullous keratopathy. J Cataract Refract Surg 33(3):455–464CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Bading G, Hillenkamp J, Sachs HG, Gabel V-P, Framme C (2007) Long-term safety and functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens implantation. Am J Ophthalmol 144(3):371–377CrossRefPubMedCentralGoogle Scholar
  23. 23.
    Vote BJ, Tranos P, Bunce C, Charteris DG, Da Cruz L (2006) Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation. Am J Ophthalmol 141(2):308–312CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Guru Nanak Eye Centre, Maulana Azad Medical CollegeNew-DelhiIndia
  2. 2.Guru Nanak Eye Centre, Maulana Azad Medical CollegeNew-DelhiIndia

Personalised recommendations