Iris-Claw Versus Scleral-Fixated Intraocular Lens Implantation for Aphakia Correction

Purpose: To compare the visual outcome and complications of posterior iris claw lens and scleral fixated posterior chamber lens. Methods: Out of 60 evaluated cases, 30 were randomly assigned in 2 group, one underwent scleral fixation and the other iris fixation. Extensive preoperative and postoperative evaluation done including Optical Coherence Tomography (OCT) and Scheimpflug imaging. Follow up done on day 1,7,28, 3 month and 6 month. Results: Significant improvement was found in Uncorrected Visual Acuity (UCVA) in both groups (p<0.001). Surgical time in Iris Fixation Intraocular Lens (ICIOL) was significantly less (P<0.001). Change in corneal astigmatism and pupil peaking and pigment release was more in ICIOL group. Mean postoperative Intraocular pressure (IOP) in both the groups was almost same (scleral fixation=15.60 ± 2.06mm Hg, iris claw=16.07 ± 2.13mm Hg). Conclusion: both the techniques had similar good visual results. Although operating time was shorter for iris fixation, it had several disadvantages, including induced astigmatism, immediate postoperative inflammation and ovalling of pupil. This makes scleral fixation a better choice.