Results of secondary retropupillary-fixated intraocular lens implantation

: Surgical treatment of intraocular lens (IOL) with late dislocation remains one of the current problems of ophthalmology.

Objective: To evaluate specific morphofunctional changes in the eye after dislocated IOL exchange with retropupillary-fixated iris-claw IOL.

Methods: Surgical outcomes of 150 patients (150 eyes) with in-the-bag IOL dislocation (122 eyes) or sulcus-fixated IOL dislocation (28 eyes) were analyzed. The follow-up period was 1-3 years.

Results: Increase in visual acuity and stable retropupillary fixation of the IOL was observed in all cases after reimplantation. Mean endothelial cell loss after 3 months was 6.9±1.3% in the group with preoperative density of >1200 cells/mm2 and 12.3±2.7% in the group with preoperative density of <1200 cells/mm2. There was no significant increase in intraocular pressure after IOL reimplantation. The incidence of clinical cystoid macular edema with decreased visual acuity was 4.7%, which is significantly more frequent than in patients after uncomplicated phacoemulsification with in-the-bag IOL implantation.

Conclusions: Retropupillary implantation of iris-claw IOL provides stable fixation, good functional outcomes with low complication rates and is suitable for reimplantation in eyes without adequate capsular support.