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Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty

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Abstract

Background

To evaluate the indication, visual outcome, and complication rate after implantation of a posterior iris-claw aphakic intraocular lens (IOL) during penetrating keratoplasty.

Methods

This retrospective study comprised 23 eyes (23 patients) without adequate capsule support undergoing posterior iris-claw aphakic IOL implantation (Verisyse™/Artisan®) during penetrating keratoplasty between 2005 and 2010. Mean follow-up was 18 months (range from 12 to 37 months).

Results

The IOLs were inserted during an IOL exchange in 17 eyes and as a secondary procedure in six aphakic eyes. Pseudophakic bullous keratopathy with corneal scar after anterior chamber intraocular lens (ACIOL) was the main indication for penetrating keratoplasty in 16 eyes (69.6 %). The final corrected distance visual acuity (CDVA) in logMAR (mean 1.0 ± 0.46) improved significantly (p < 0.05) compared to the preoperative CDVA (mean 1.8 ± 0.73). Twenty eyes (86.9 %) had a final visual acuity in logMAR better than the pre-operative CDVA. The mean postoperative IOP 16.3 mmHg ± 4.0 was not significantly (p > 0.05) higher compared to the preoperative IOP 15.6 mmHg ± 5.1. Complications included slight temporary pupil ovalization in three eyes (13.0 %) and iris-claw IOL sublocation in three eyes (13.0 %); all IOLs could be easily repositioned. Cystoid macular edema occured in one eye (4.3 %) 8 weeks after primary surgery. All grafts remained clear without any sign of graft rejection.

Conclusions

Retropupillar iris-claw IOL during penetrating keratoplasty provides good visual outcomes with a favorable complication rate, and can be used for a wide range of indications in eyes without adequate capsule support.

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Acknowledgments

Anna-Karina B. Maier: Financial support provided by the “Friedrich C. Luft” Clinical Scientist Pilot Program funded by Volkswagen Foundation and Charité Foundation.

Conflict of interest

None to declare.

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Authors and Affiliations

  1. Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Johannes Gonnermann, Necip Torun, Matthias K. J. Klamann, Anna-Karina B. Maier, Christoph v. Sonnleithner, Antonia M. Joussen, Peter W. Rieck & Eckart Bertelmann

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  1. Johannes Gonnermann
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  2. Necip Torun
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  3. Matthias K. J. Klamann
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  4. Anna-Karina B. Maier
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  5. Christoph v. Sonnleithner
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  6. Antonia M. Joussen
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  7. Peter W. Rieck
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  8. Eckart Bertelmann
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Corresponding author

Correspondence to Johannes Gonnermann.

Additional information

Johannes Gonnermann and Necip Torun are joint first authors.

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Gonnermann, J., Torun, N., Klamann, M.K.J. et al. Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol 251, 1151–1156 (2013). https://doi.org/10.1007/s00417-012-2226-y

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  • DOI: https://doi.org/10.1007/s00417-012-2226-y

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