Surgical outcome of retropupillary iris-claw lens implantation: a retrospective review

Introduction: Intraocular lens (IOL) selection, especially in cases with insufficient capsular and/or zonular support has increasingly become a challenge to surgeons. Retropupillary iris-claw IOLs (RP-ICIOL) have gained popularity in recent years.Purpose: This study aimed to review the outcomes of RP-ICIOL implantation in two tertiary eye centres.Study design: Retrospective review.Methods: This is a retrospective study of 14 eyes of 14 patients who underwent Artisan RP-ICIOL implantation between November 2018 and December 2020 in two tertiary eye centres in Malaysia.Results: The mean age of patients was 51.5 ± 17.4 years with the range between 18 and 77 years old. There were ten (71.4%) males and four (28.6%) females. The IOL was implanted primarily in three eyes (21.43%) and as a secondary procedure in eleven eyes (78.6%). Mean preoperative best-corrected visual acuity (BCVA) was logMAR 1.32 ± 0.82, while mean postoperative BCVA was logMAR 0.56 ± 0.42 (p = 0.010). Visual improvement of two or more lines in BCVA was observed in nine eyes (64.3%), no improvement in two eyes (14.3%), and worsening in three eyes (21.4%). There were no complications observed during the surgery. All our patients had a well-centred IOL at the 1-month postoperative follow-up. Mean preoperative intraocular pressure was 16.8 ± 2.0 mmHg and postoperative intraocular pressure was 15.7 ± 5.1 mmHg (p = 0.430).Conclusion: RP-ICIOL implantation is safe and provides the optical advantage of a more biologically appropriate retropupillary position, ensuring a favourable functional visual outcome with low risk of complications.