Visual Outcomes and Complications of Iris Claw Intraocular Lens Implantation in Aphakic Patients

Purpose: This study aims to assess the visual outcomes and postoperative complications in aphakic patients who underwent iris-claw intraocular lens Implantation particularly in cases lacking adequate capsular support for conventional IOL placement.

Methods:  This prospective clinical study was conducted over 6 months at PES Institute of Medical Sciences and Research and included 24 aphakic eyes. Patients with aphakia secondary to complicated cataract surgery or ocular trauma, lacking sufficient capsular support for conventional IOL implantation were enrolled. Preoperative assessment included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and intraocular pressure (IOP) measurement and ocular biometry using A-scan and B-scan ultrasonography where indicated. All patients underwent iris-claw IOL implantation and were followed up at regular intervals for six months. Postoperative evaluation included BCVA, refractive outcomes, and complications such as cystoid macular edema (CME), disenclavation, pupil ovalization, and raised IOP.

Results: A significant improvement in visual acuity was observed in the majority of patients. More than 90% of eyes achieved a postoperative refractive error within ±2.00 diopters of emmetropia. The most common complication was pupil ovalization (24%), followed by CME (8%) and IOL disenclavation (8%). Elevated IOP was noted in 4% of cases. Rare complications, including hyphema, uveitis, and endophthalmitis, occurred in less than 1% of eyes.

Conclusion: Iris-claw IOL implantation is a safe and effective option for visual rehabilitation in aphakic patients without capsular support. Short-term follow-up demonstrates favorable visual outcomes with an acceptable complication profile, supporting its role as a reliable secondary IOL implantation technique.