Mikhail Aleksandrovich Frolov , Vinod Kumar, Isufaj Edmond

Department of ophthalmology, Russian peoples friendship university, Moscow

Ophthalmic unit of Skhodnya city hospital, Moscow region, Russia

LONG TERM RESULTS OF RETROPUPILLARY FIXATION OF AN IRIS-CLAW INTRAOCULAR LENS

(ICIOL) IN MANAGEMENT OF COMPLICATIONS DURING PHACOEMULSIFICATION.

FINANCIAL DISCLOSURE: none.Innovative educational program of the university

Department of ophthalmology, Russian peoples friendship university, Moscow

INTRODUCTION

The ideal and best place for IOL implant is in the capsular bag.

However in the presence of an unstable capsule-zonule complex or its absence, endocapsular fixation of an IOL is a difficult target to achieve and the surgeon has four following options:

to implant an ACIOL; to fixate a PCIOL in the iris;to fixate a PCIOL in the sclera;to leave the eye aphakic.

Department of ophthalmology, Russian peoples friendship university, Moscow

Purpose: To evaluate long term results of retropupillary fixation of ICIOLs in management of intraoperative complications during phacoemulsification.

Setting: Department of ophthalmology, Russian People’s Friendship University, Moscow Ophthalmic unit of Skhodnya city hospital, Moscow region, Russia.

MATERIAL AND METHODS

Department of ophthalmology, Russian peoples friendship university, Moscow

• The study was done under the innovative educational program of the university.

• Retropupillary fixation of an ICIOL in 21 eyes of 20 patients (9 male and 11 females).

• The patients age varied from 38 to 87yrs. (average age: 71,4+/-11,8 yrs.)

• Follow-up period from 1 year to 4 years.

MATERIAL AND METHODS

Department of ophthalmology, Russian peoples friendship university, Moscow

ICIOL was implanted during following intraoperative complications :

•Posterior capsule rupture with vitreous prolapsed into anterior chamber - 7 eyes.

•Zonular dehiscence - 14 eyes.

Department of ophthalmology, Russian peoples friendship university, Moscow

• Visual acuity

• Refraction

• Intraocular pressure (IOP) measured by Maklakov method

• IOL stability

MAIN OUTCOME MEASURES

SURGICAL TECHNIQUE

RESULTS• Visual acuity of 0.5 or more was achieved in 15 cases (71.4%)

• During follow-up position of IOL remained stable in all cases.

• No new case of glaucoma was diagnosed.

• Iridopseudophacodonesis was prevalent in all cases.

• 5 cases (23.8%) with pupil deformation in the form of “cat pupil” complained of glare.

RESULTS

• Depigmentation areas at enclavation site, observed in most of the cases (16 cases, 76.2%) were related to surgical trauma while enclaving the iris.

• Ultrasound biomicroscopy showed contact between IOL and iris only at enclavation site. IOL optic was well away from iris tissue.

CONCLUSION

Department of ophthalmology, Russian peoples friendship university, Moscow

Analysis of long term results indicates safety and effectiveness of retropupillary fixation of an ICIOL in management of complications during phacoemulsification.