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. 2025 Jul;14(7):1491-1501.
doi: 10.1007/s40123-025-01153-8. Epub 2025 May 14.

Surgical Outcomes of Retropupillary Iris-Claw Intraocular Lens Implantation for Various Indications

Hyo Song Park  1   2 , Sung Chul Park  2 , Jin Ha Kim  1   2 , Young Hoon Ohn  1   3 , Tae Kwann Park  1   2 , Jung Woo Han  4   5
Affiliations

Surgical Outcomes of Retropupillary Iris-Claw Intraocular Lens Implantation for Various Indications

Hyo Song Park et al. Ophthalmol Ther. 2025 Jul.

Abstract

Introduction: The retropupillary iris-claw intraocular lens (RP-IOL) offers a sutureless solution to complications like aphakia, intraocular lens (IOL) dislocation, and opacification post-cataract surgery. Unlike time-consuming, complication-prone traditional methods, RP-IOL potentially reduces surgical time and complications. This study evaluates RP-IOL's clinical outcomes to assess its efficacy and safety.

Methods: This single-center retrospective case series reviewed medical records of 68 eyes from 68 patients who underwent RP-IOL implantation between January 2017 and May 2023. Preoperative and postoperative data, including visual acuity (VA), intraocular pressure (IOP), and spherical equivalent (SE), were analyzed.

Results: The mean uncorrected VA improved significantly from 1.25 ± 0.73 (logarithm of the minimum angle of resolution) preoperatively to 0.42 ± 0.47 at 1 month postoperatively (P < 0.001). The mean IOP decreased significantly from 17.69 ± 5.01 mmHg preoperatively to 16.09 ± 4.23 mmHg 1 month postoperatively (P = 0.041). Postoperative complications occurred in 35.3% of cases, with the most common being IOP elevation (13.2%), cystoid macular edema (11.8%), and disenclavation of IOL (7.4%). Most complications were successfully managed. The study also included a subanalysis of seven patients with IOL opacification, showing improved VA postoperatively, although without statistical significance due to the small sample size.

Conclusions: RP-IOL implantation is an effective and safe option for secondary IOL implantation or exchange in cases of aphakia, IOL dislocation, and IOL opacification. The procedure offers significant improvements in visual acuity and a reduction in intraocular pressure, with manageable postoperative complications. While the study supports the use of RP-IOL as a viable option, further research with larger sample sizes and prospective designs is recommended to establish its long-term efficacy and safety compared to traditional methods.

Keywords: IOL dislocation; IOL opacification; Retropupillary iris-claw IOL.

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Conflict of interest statement

Declarations. Conflict of Interest: Hyo Song Park has nothing to disclose. Sung Chul Park has nothing to disclose. Jin Ha Kim has nothing to disclose. Young Hoon Ohn has nothing to disclose. Tae Kwann Park has nothing to disclose. Jung Woo Han has nothing to disclose. Ethical Approval: Ethical approval for this study was obtained from the institutional review board of Soonchunhyang University Hospital (IRB No.2024-06-009). The requirement of informed consent was waived due to the retrospective nature of the study, and the data were anonymized before the analysis. Informed consent was waived from the IRB due to the retrospective design.

Figures

Fig. 1
Fig. 1
Surgical procedures for retropupillary iris-claw intraocular lens implantation
Fig. 2
Fig. 2
Changes in A visual acuity and B intraocular pressure before and after retropupillary iris-claw intraocular lens implantation. The small black dots represent mean data points and error bars represent standard deviations. Pre preoperative, Post postoperative days, M month, BC best-corrected. *P < 0.05. †P < 0.001
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