RETROPUPILLARY IRIS-CLAW INTRAOCULAR LENS AND PARS PLANA VITRECTOMY IN APHAKIA MANAGEMENT: A National Multicenter Audit.
Bernal-Morales Carolina, Hernández-Martínez Adrián, Navarro-Angulo Manuel J, Ruiz-Miguel Miguel, Rodriguez-Maqueda Mariano, Velazquez-Villoria Daniel, Cubero-Parra Juan Manuel, Marticorena Joaquín, Ruiz-Casas Diego, Adan Alfredo
AI Summary
This audit of 325 eyes found retropupillary iris-claw IOLs achieved good vision in most aphakic patients, but showed significant rates of elevated IOP and macular edema, crucial for patient counseling.
Abstract
Purpose
To evaluate the outcomes and safety of retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy.
Methods
Multicenter, national audit of 325 eyes (325 patients). Demographics, surgical details, and complications are described. Visual acuity, intraocular pressure, and central retinal thickness assessed by optical coherence tomography were collected at 1, 3, 6, and 12 months after surgery. Kaplan-Meier curves were created to assess the cumulative probability of postoperative visual acuity and intraocular pressure levels, macular edema development, and corneal decompensation.
Results
The cumulative probability of the final visual acuity ≤0.3 logarithm of the minimum angle of resolution (≥20/40 Snellen) was 75.6% at 12-month follow-up. The probability of intraocular pressure >21, ≥25, and ≥30 mmHg was 48.1%, 33.1%, and 19.0%, and the probability of intraocular pressure-lowering drops was 50.9% at 12 months. Glaucoma surgery was required in 4.3% of the eyes (14/325). The cumulative probability of macular edema was 20.5% at 12 months and was greater in complicated cataract surgery than in intraocular lens-luxation eyes (26% vs. 16.7%, P = 0.04). Corneal transplantation was required in 2.8% of the eyes (9/325).
Conclusion
This study on 325 eyes with aphakia or intraocular lens dislocation managed with the retropupillary iris-claw intraocular lens technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counseling and preoperative discussions.
MeSH Terms
Shields Classification
Key Concepts6
The cumulative probability of final visual acuity ≤0.3 logarithm of the minimum angle of resolution (≥20/40 Snellen) was 75.6% at 12-month follow-up in eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation.
The probability of intraocular pressure >21 mmHg was 48.1%, ≥25 mmHg was 33.1%, and ≥30 mmHg was 19.0% at 12 months in eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation.
The probability of requiring intraocular pressure-lowering drops was 50.9% at 12 months in eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation.
Glaucoma surgery was required in 4.3% (14/325) of eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation.
The cumulative probability of macular edema was 20.5% at 12 months in eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation, and was greater in complicated cataract surgery cases than in intraocular lens-luxation eyes (26% vs. 16.7%, P = 0.04).
Corneal transplantation was required in 2.8% (9/325) of eyes managed with retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy for aphakia or intraocular lens dislocation.
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