Posterior Iris-Claw Lens – A Boon to Budding Cataract Surgeons

Abstract

Aim: The aim was a retrospective comparative study on visual outcomes and complications of retro-pupillary fixated iris-claw lens (RPICL) with respect to  the experience level of the operating surgeons.

Methods and Materials: A retrospective study in which records of 126 patients who had RPICL implanted  following cataract surgery between January  and December 2020 at our hospital were analyzed. Patients were categorized into two groups: (a) RPICL done  by a consultant (with experience of a minimum of 25 RPICL done) and (b) RPICL done by a resident (less than two RPICL done, with assistance).  Visual outcome (best-corrected visual acuity in  logMAR) and postoperative complications (on the first postoperative day and one month) were analyzed in  the two groups.

Results: There was a total of  126 eyes in 126 patients, of which primary RPICL was implanted in 45 eyes by the consultants (group A)  and 81 eyes by the residents (group B). Overall  ocular risk factors warranting a difficult surgery were significantly higher in the consultant group when  compared with the resident group (P = 0.001).  Mean preoperative vision was 0.899 and 1.137 in group A and group B, respectively. The final postoperative  vision (postoperative period 1 month) was  0.246 and 0.332 in group A and group B, respectively. There was no statistically significant  difference in preoperative and postoperative vision between  both groups. Postoperative complications on day 1 were more in group B (71.6%) than in  group A (55.6%) (P = 0.054). However, most of them resolved  within 1 month postoperative period.

Conclusion: Primary RPICL implantation is an effective modality of visual rehabilitation in complicated cataract  surgery with deficient capsular support and is a boon for young budding cataract surgeons.