Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Long-term Results of Posterior Iris-Claw Lens Implantation and a Comparative Analysis with the Fellow Eye
İris Arkasına İntraoküler Lens İmplantasyonu Uzun Dönem Sonuçlarımız ve Diğer Gözle Karşılaştırılması
Cansu ERSEVENa, Huri SABURa, Mehmet BAYKARAa
aDepartment of Ophthalmology, Uludağ University Faculty of Medicine, Bursa, TURKEY
Turkiye Klinikleri J Ophthalmol. 2021;30(2):115-22
doi: 10.5336/ophthal.2020-79285
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the long-term results of primary and secondary posterior iris-claw intraocular lens (IOL) implantation and a comparative analysis with the fellow eye Material and Methods: One hundred-one eye of 99 patients who underwent iris-claw IOL implantation were included in this retrospective study. Data recorded for each subject consisted of preoperative and postoperative spherical equivalent (SE), best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell count (ECC) values, and biomicroscopic findings. Patients were divided into two main groups according to primary (complicated cases) and secondary (aphakic cases) implantation. The comparison of the groups was made in terms of SE, BCVA, IOP, CCT, and ECC values. Also, postoperative CCT and ECC comparison was made between the fellow eye and irisclaw IOL implanted eyes. Results: Median duration of follow-up was 44.6 (range 1-83) months. While postoperative SE, IOP, CCT values were similar in two groups (p=0.754, p=0.621, p=0.520, respectively), postoperative BCVA and ECC values were statistically higher in the aphakic group than the complicated group (p=0.048, p=0.004, respectively). ECC values in iris-claw IOL-implanted eyes were lower than the same patients' fellow phakic eyes (p=0.003), but there was no statistically significant difference between iris-claw IOL-implanted eyes and the fellow pseudophakic eyes for ECC values (p=0.520). Conclusion: Although retropupillary iris-claw IOL fixation with scleral tunnel might be challenging, it is a safe and effective method with better visual and refractive outcomes.

Keywords: Lens implantation, intraocular; aphakia; secondary intraocular lens implantation; endothelial cell count
ÖZET
 Amaç: Birincil veya ikincil olarak iris arkasına iris kıskaçlı lens (İKL) implantasyonu uygulanan hastaların uzun dönem sonuçlarının incelenmesi ve diğer gözle karşılaştırılmasıdır. Gereç ve Yöntemler: Bu retrosprektif çalışmaya iris arkasına İKL implantasyonu uygulanan 99 hastanın 101 gözü dâhil edildi. Olguların ameliyat öncesi ve ameliyat sonrası sferik eşdeğer (SE), en iyi düzeltilmiş görme keskinliği (EİDGK), göz içi basınç (GİB), santral kornea kalınlığı (SKK), endotel hücre sayısı (ES) ve biyomikroskobik bulguları kaydedildi. Hastalar primer (komplike vakalar) ve sekonder (afakik vakalar) implantasyon yapılmasına göre 2 ana gruba ayrıldı. Gruplar SE, EİDGK, GİB, santral kornea kalınlığı (SKK) ve endotel sayısı (ES) açısından karşılaştırıldı. Ayrıca İKL takılan gözlerle hastaların diğer gözleri arasında postoperatif SKK ve ES karşılaştırılması yapıldı. Bulgular: Ortanca takip süresi 44,6 (1-83) ay idi. Postoperatif SE, GİB, SKK değerleri her iki grupta birbiri ile benzer iken (sırasıyla p=0,754, p=0,621, p=0,520), postoperatif EİDGK ve ES değerleri istatistiksel anlamlı olarak afakik grupta komplike gruba göre daha yüksekti (sırasıyla p=0,048, p=0,004). İKL implantasyonu uygulanan gözlerin ES değerleri, aynı hastaların fakik olan diğer gözlerine göre daha düşüktü (p=0,003), ancak İKL implantasyonu uygulanan gözlerle psödofakik olan diğer gözleri arasında ES değerleri açısından istatistiksel olarak anlamlı bir farklılık yoktu (p=0,520). Sonuç: Skleral tünelden iris arkasına İKL implantasyonu implantasyon zor olabilmesine rağmen, daha iyi görsel ve refraktif sonuçlara sahip güvenli ve etkili bir yöntemdir.

Anahtar Kelimeler: Lens implantasyonu, göz içi; afaki; ikincil intraoküler lens implantasyonu; endotel hücre sayısı
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