Case Series Of 6 Cases Of Keratoplasty With Retrofixation Of Iris Claw Lens

Sagar Kharosekar MSAjay K MS, Chetan A MS

Suchi Smita MS, Sri Ganesh MS

The authors have no financial interest

We have no financial interest

• Purpose:

To study results of 5 cases of PK &1 case of descemet’s stripping femtosecond laser assisted endothelial keratoplasty with retrofixation of Iris claw lens with min. F/U of 6 mths.

Methods

• In cases without posterior capsule where keratoplasty is requiredretrofixated Iris claw lens after +/- ACIOL explantation & anterior vitrectomy donein cases of bullous keratopathy

• Routine post op F/U up & treatment done.

Methods

• Iris enclavation areas monitered by UBM at 3 & 6 mths.

• IOL and Iris planes compared on UBM • AC & vitreous cells monitered postop at

1,2,4,12 & 24wks . • Pre and post op BCVA at 6 mths compared.

Results

• Iris enclavation was firm in all cases till last follow up in all 6 cases.

• Iris & IOL planes were parallel in all 6 cases without any tilt.

• No cases had postop uveitis.

Results

• 1 case had acute allograft rejection at 8 wks• 1 had graft infiltrate (GPC in pairs) which led

to graft failure at 11 wks Still till last F/U, retrofixated IOL was well in place.

• In rest of the cases, BCVA improved from average 1.4/60, <N36

to 6/24, N 8.6 at 6 mths.

Conclusion

• Retrofixation of Iris claw lens appears to be good alternative to SFIOL or aphakic CLsin cases without posterior capsule where keratoplasty is needed

• Further long term studies comparing results with SFIOL cases are of course required to know the efficacy & safety of these lenses.

Conclusion

• Iris atrophy leading to late slippage of the lens on long term seems unlikely but needs to be monitered and studied.

• Can be used with even dilated, fixed irregular pupils provided we get a good chunk of iris for enclavation on both sides.

Thank you