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. 2021 Feb 27;14(1):20-26.
doi: 10.4103/ojo.OJO_91_2020. eCollection 2021 Jan-Apr.

Comparison of retropupillary fixated iris claw lens versus sclera fixated lens for correction of pediatric aphakia secondary to ectopia lentis

Bhavatharini Muthukumar  1 , Preeti Patil Chhablani  2 , Amjad Salman  3 , Vipul Bhandari  4 , Rajat Kapoor  2
Affiliations

Comparison of retropupillary fixated iris claw lens versus sclera fixated lens for correction of pediatric aphakia secondary to ectopia lentis

Bhavatharini Muthukumar et al. Oman J Ophthalmol. .

Abstract

Aim: To evaluate the postoperative visual acuity and complications in eyes with ectopia lentis in children who underwent lens removal and then implantation of retropupillary fixated iris claw lens versus scleral fixated intraocular lens (SFIOL) implantation.

Materials and methods: A retrospective analysis of pediatric cases who presented with lens subluxation secondary to ectopia lentis and who underwent lens extraction (57 eyes of 38 patients) with either retropupillary iris fixated intraocular lens (IOL) implantation (Group A - 36 eyes of 20 patients) and SFIOL implantation (Group B - 21 eyes of 18 patients) was done over a period of 5 years from March 2010 to February 2015. The main outcome measures were preoperative and postoperative best-corrected visual acuity (BCVA) and secondary postoperative complications.

Results: The study patients were divided into two groups: Group A patients were implanted with retropupillary iris claw lens whereas Group B patients were implanted with SFIOL. The mean age of presentation was 12 years, the mean follow-up period was of 24 months (range 14-36 months), and the median follow-up period was 26 months in both the groups. An improvement in the mean BCVA (LogMAR) was seen in both the groups. In Group A, the mean BCVA improved from 1.5 ± 0.2 preoperatively to 0.3 ± 0.2 postoperatively, whereas in Group B, the mean BCVA improved from 1.5 ± 0.3 preoperatively to 0.3 ± 0.2 postoperatively (P < 0.001). None of the eyes in either of the groups had any serious complications such as glaucoma, uveitis, cystoid macular edema, or endophthalmitis.

Conclusion: Retropupillary iris fixation and scleral fixation of IOL are both safe and viable options for the correction of ectopia lentis in pediatric age group.

Keywords: Aphakia; Marfan syndrome; ectopia lentis; iris claw lens; scleral fixated intraocular lens; scleral fixated lens.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Slit lamp photograph showing superotemporal subluxation of lens in Marfan syndrome
Figure 2
Figure 2
Postoperative day 1 picture showing iris claw lens (Group A) with a superior peripheral iridectomy (white arrow)
Figure 3
Figure 3
Postoperative day 1 picture showing scleral fixated intraocular lens (Group B)
Figure 4
Figure 4
Postoperative 2 months picture showing iris claw lens in place post pupil dilatation
Chart 1
Chart 1
Patient distribution in Groups A and B
Figure 5
Figure 5
Age distribution in Groups A and B
Figure 6
Figure 6
Gender distribution in Groups A and B
Figure 7
Figure 7
Box plot comparing preoperative and postoperative best-corrected visual acuity in Group A – iris claw intraocular lens
Figure 8
Figure 8
Box plot comparing preoperative and postoperative best-corrected visual acuity in Group B – scleral fixated intraocular lens
Figure 9
Figure 9
Complications in Groups A and B
See this image and copyright information in PMC

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